The past 12 months have yielded several interesting developments in our understanding of normal esophageal physiology and esophageal motor disorders and their management. Further insigts into the control of swallowing and esophageal peristalsis have come from the use of transcranial electromgnetic stimulation, investigation of pharyngeal sensation, and studies into the roles of inhibitory neurotransmitters and clacium. The activity of the longitudinal muscle is assuming increasing importance in esophageal peristalsis and esophageal transport. Achalasis continues to attract considerable interest with a further report of antienuronal antibodies and investigations of esophageal tone, inhibitory innervation, and gastroesophgeal reflux. There is continued interest in the use of botulinum toxin, not only for the treatment of achalsia, but also for the treatment of the treatment of other motor disorders such as esophageal muscular rings and esopheal diverticula. Several studies have assessed laparocopic myotomy for the treatment of achalasia. Ambulatory manometry has been evaluated for the diagnosis of diffuse esophageal spasm.
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