Esophageal motor disorders

This review summarizes important recent advances in the areas of esophageal motility and motility disorders. Several studies in 1996 have examined the central and enteric neural control of swallowing. The technique of transcranial magnetic stimulation has increased the understanding of the cortical control of swallowing in conscious human subjects. Studies of the chemical coding of the enteric nerves that regulate esophageal motility continued to focus on the important role of nitric oxide. Achalasia and gastroesophageal reflux disease (GERD) are the two motility disorders that received the most attention in the recent literature. Several studies on the treatment of achalasia evaluated the effectiveness of intrasphincteric botulinum toxin and laparoscopic myotomy. Other studies examined the mechanisms of the transient lower esophageal sphincter relaxations that are responsible for GERD and the usefulness of manometric testing in the evaluation of this disorder.