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Topic: Lower esophageal sphincter

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Sphincter

Pylorus

Stomach

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Pyloric sphincter

	THE MERCK MANUAL OF GERIATRICS, Ch. 105, Esophageal Disorders
		A neurogenic esophageal disorder of unknown cause characterized by impaired esophageal peristalsis and a lack of lower esophageal sphincter relaxation.
		In achalasia, lower esophageal resting pressure is increased and intraesophageal pressure is increased relative to gastric pressure.
		A modified Heller's procedure (anterior myotomy of the circular muscle fibers of the lower esophageal sphincter, preserving the sphincter competency) is successful in 80 to 90% of patients.
	www.merck.com /mrkshared/mmg/sec13/ch105/ch105c.jsp (620 words)

	What is the role of an inadequate control of the lower esophageal sphincter (structure, position, innervation, hormonal ...
		The main problem until recent years was to demonstrate an anatomical structure on distal esophagus that matched to the classical concept of a sphincter, that is, a distinct ring of a thickened circular muscle separated from the adjoining muscles by connective tissue septums [1, 5].
		Winans challenged the classic concept of a circular sphincter in 1977, when he demonstrated a manometric asymmetry of the lower esophageal sphincter (LES) [6].
		A recent study has shown that the manometric three-dimensional pressure images of the lower esophageal high-pressure zone correlates with the radial and longitudinal asymmetry of muscular structures at the GEJ [8].
	www.hon.ch /OESO/free/Vol_6_Barrett_s_Esophagus/Articles/vol1/art003.html (512 words)

	Achalasia - Evanston Northwestern Healthcare (Site not responding. Last check: 2007-11-05)
		The lower esophageal sphincter is a muscular ring at the junction of the esophagus and the stomach.
		Achalasia is a disorder in which the lower esophageal sphincter does not relax when food passes down the esophagus to the stomach.
		To open the esophagus, a balloon dilator is passed through the mouth down to the level of the lower esophageal sphincter, using an endoscope.
	www.enh.org /healthandwellness/encyclopedia/surgery/100143.aspx (391 words)

	Relationship Between Diffuse Esophageal Spasm and Lower Esophageal Sphincter Dysfunction on Barium Studies and ...
		the lower esophageal sphincter in patients with achalasia [5, 6].
		the proximal border of the lower esophageal sphincter.
		Diffuse esophageal spasm is characterized on manometry by intermittently abnormal
	www.ajronline.org /cgi/content/full/183/2/409 (3499 words)

	Gastroesophageal Reflux Disease and the Otolaryngologic Manifestations
		The lower esophageal sphincter is considered the greatest barrier to preventing gastric reflux.
		There are several factors that are implicated in the development of reflux esophagitis, including (1) length of time the gastric contents are in contact with the esophageal mucosa, (2) the potency of the gastric contents, and (3) the capacity of the esophagus to neutralize and clear the caustic contents from the mucosal surface.
		As previously discussed, lower esophageal sphincter pressure is low at birth and progressively matures to normal adult levels at 6 months of age; furthermore, the cardiac angle is obtuse at birth, gradually becoming acute with growth.
	www.otohns.net /default.asp?id=15313 (6737 words)

	Esophageal manometry and ambulatory esophageal pH testing
		The lower esophageal sphincter is a one-way valve between the esophagus and stomach.
		Esophageal manometry is a test that takes approximately 30 minutes and does not have to be performed in the hospital.
		For example, if the Lower Esophageal pressures are low, this may suggest acid reflux into the esophagus (acid going back from the stomach into the esophagus) as the cause to the patient’s problem.
	www.gidoctors.com /Emanometry/Emanometry.htm (1371 words)

	What is the relationship of lower esophageal mucosal rings to lower esophageal sphincter pressure, abnormal ...
		The lower esophageal mucosal ring (LEMR) is an acquired thin membrane that demarcates the esophagogastric junction, and a criterion used to diagnose hiatal hernia (Figure 1).
		Abnormal gastroesophageal reflux (GER) and reflux esophagitis have a multifactorial pathogenesis.
		However, lower esophageal sphincter dysfunction is an important cause, seen as transient or prolonged episodes of hypotension of the lower esophageal sphincter (LES) pressure.
	www.hon.ch /OESO/free/Vol_5_Eso_Junction/Articles/art413.html (300 words)

	Raj K. Goyal, M.D.
		Brain stem circuits in swallowing reflex and transient lower esophageal sphincter: In these studies, superior laryngeal nerve and the subdiaphragmatic gastric branches of the vagus are electrically stimulated in the anesthetized mice to elicit swallow-associated esophageal peristalsis and lower esophageal sphincter relaxation.
		Esophageal motility is recorded by intraluminal manometry and c-fos expression in the brain stem neurons elicited by the above nerve stimulation is examined.
		The esophageal non-sphincter muscle has a relatively higher ratio of gamma to alpha action, a different myosin isoform, ratio of and caldesmon to calponin as compared to the lower esophageal sphincter.
	www.brighamandwomens.org /gastroenterology/research/goyal.aspx (941 words)

	Motility Disorders of the Esophagus - aboutGIMotility.org
		The lower esophageal sphincter (or LES) is a muscle that separates the esophagus from the stomach.
		This happens when the lower esophageal sphincter (LES) separating the stomach from the esophagus does not work properly; the function of this sphincter is to prevent reflux from occurring when the stomach contracts.
		Treatment is aimed at reducing the elevated pressure of the lower esophageal sphincter either by medications (nitrates, calcium blockers), botulism toxin injection, balloon dilation, or surgery (myotomy).
	www.aboutgimotility.org /site/about-gi-motility/disorders-of-the-esophagus (642 words)

	Postgraduate Medicine: Peptic Acid Disease Symposium: Complications of gastroesophageal reflux disease
		Stein and associates (2) found that a mechanically defective lower esophageal sphincter was present in 65% of patients with esophagitis, 89% of those with esophageal stricture, and 93% of patients with Barrett's esophagus.
		If the lower esophageal segment has been displaced up into the chest, the pincerlike effect of the diaphragmatic crura is ineffective in closing off the esophagus to reflux (3).
		The risk of esophageal carcinoma in patients with Barrett's esophagus is 30 to 50 times higher than in the general population and is proportional to the extent of columnar metaplasia.
	www.postgradmed.com /issues/1996/11_96/clark.htm (2831 words)

	Gastroesopageal Reflux Disease...(Feb.1999)
		The antireflux barrier may be roughly broken down to four lines of defense – (1) the lower esophageal sphincter, (2) esophageal acid clearance, (3) epithelial resistance, and (4) the upper esophageal sphincter.
		Finally, the crural diaphragm is felt to impart a "phasic" component to the tonic high pressure of the lower esophageal sphincter, based on EMG studies.
		Histologically, reflux esophagitis is characterized by basal cell hyperplasia resulting in increased length of the stroma pili, an eosinophilic infiltrate, and a non-specific polymorphonuclear / lymphocyte infiltration.
	www.utmb.edu /otoref/Grnds/GERD-9902/GERD-9902.html (7705 words)

	Esophageal manometry
		Esophageal manometry is a test to measure the motor action of the lower esophageal sphincter (LES) and esophageal body.
		A catheter is used to measure esophageal pressure and records the duration and sequence of contractions in the esophagus.
		The transducer records the high pressure zone of the lower esophageal sphincter (LES), the sphincter muscle that acts as a valve to prevent reflux of gastric acid into the esophagus.
	www.pennhealth.com /ency/article/003884.htm (483 words)

	Lower esophageal sphincter (LES) - barrettsinfo.com
		The most important valve for keeping stomach contents out of the esophagus and airway is the lower esophageal sphincter, referred to as the LES.
		The LES normally opens or relaxes (lowers its pressure) as food is moved down the esophagus by esophageal contractions.
		In the normal esophagus, in response to transient LES relaxations and the backwash of gastric contents into the esophagus, strong esophageal contractions are initiated to force refluxed stomach contents back down into the stomach and clear the esophagus of acid.
	www.barrettsinfo.com /content/info_2b1_les.htm (697 words)

	Lower esophageal sphincter - Wikipedia, the free encyclopedia
		In anatomy, the lower esophageal sphincter is the muscular area where the esophagus meets the stomach.
		It is also known as the gastroesophageal sphincter and the cardiac sphincter.
		The sphincter serves as a one way valve.
	en.wikipedia.org /wiki/Lower_esophageal_sphincter (215 words)

	Esophageal Manometry - Digestion and digestive-related information on MedicineNet.com
		Esophageal manometry is a procedure for determining how well the muscle of the esophagus works when diseases of the muscle are suspected.
		At the upper and lower ends of the esophagus are two short areas of specialized muscle called the upper and lower esophageal sphincters.
		The most common use for esophageal manometry is to evaluate the lower esophageal sphincter in patients who have gastroesophageal reflux disease (GERD).
	www.medicinenet.com /esophageal_manometry/article.htm (649 words)

	Achalasia symptoms, signs, diagnosis and treatment on MedicineNet.com
		Dilation of the lower esophageal sphincter is done by having the patient swallow a tube with a balloon on the end.
		The newest treatment for achalasia is the endoscopic injection of botulinum toxin into the lower sphincter to weaken it.
		Achalasia is a rare disease of the muscle of the lower esophageal body and the lower esophageal sphincter.
	www.medicinenet.com /achalasia/page5.htm (821 words)

	The hypertensive esophageal sphincter: Prevalen...
		Background: The hypertensive lower esophageal sphincter (HLES) is an unusual primary motor disorder of the esophagus.
		Upon comparing manometric data of patients with HLES and healthy control subjects the motor function of the esophageal body, the total length of the lower esophageal sphincter, and its position in respect to the diaphragm were similar in both groups.
		Total length of the sphincter, as well as length of the thoracic and abdominal segments do not appear to contribute to high basal pressure.
	www.imbiomed.com /Gastro/Gav66n4/english/Zga014-01.html (248 words)

	Laparoscopic Fundoplication (Site not responding. Last check: 2007-11-05)
		Some patients with persistent or recurrent reflux may benefit from surgical correction of the weakness in the lower esophageal sphincter mechanism that under normal conditions would prevent the backwash of gastric contents into the esophagus and throat (figures 1 and 2).
		Surgical reconstruction of this lower esophageal sphincter has also been shown to be an effective means of reversing the esophageal injury that results from reflux of acidic gastric contents.
		The three functional variables of the lower esophageal sphincter that are important in determining its competency are lower sphincter pressure, intra-abdominal sphincter length, and overall sphincter length.
	www.upmc.edu /minsurg/LapFund.htm (1815 words)

	Effect of Lower Esophageal Sphincter Distension and Acidification on Esophageal Pressure and Electromyographic ...
		Effect of Lower Esophageal Sphincter Distension and Acidification on Esophageal Pressure and Electromyographic Activity: The Identification of the "Sphinctero-Esophageal Excitatory Reflex" -- Shafik et al.
		Effect of Lower Esophageal Sphincter Distension and Acidification on Esophageal Pressure and Electromyographic Activity: The Identification of the "Sphinctero-Esophageal Excitatory Reflex"
		lower esophageal sphincter dilatation is suggested to be reflex
	ats.ctsnetjournals.org /cgi/content/abstract/79/4/1126 (325 words)

	Esophageal cancer: Causes - MayoClinic.com
		Another ring of muscle, the lower esophageal sphincter, sits at the junction where your esophagus and stomach connect.
		The most common esophageal cancer in fl Americans and the most prevalent esophageal cancer worldwide, squamous cell carcinoma develops in the flat squamous cells that line the esophagus.
		In this disorder, food collects at the bottom of the esophagus, both because the esophagus lacks normal peristalsis to move food along and because the lower esophageal sphincter doesn't relax normally.
	www.mayoclinic.com /health/esophageal-cancer/DS00500/DSECTION=3 (994 words)

	Gastroesophageal Reflux Disease (GERD)
		Acid refluxing occurs when the sphincter between the esophagus and the stomach, the lower esophageal sphincter, doesn't work properly or when a hiatal hernia has developed (when part of the stomach protrudes up through the diaphragm-the muscular layer between the abdomen and the chest) and into the chest.
		The lower esophageal sphincter must have sufficient length below the diaphragm and muscle tone to prevent the backwash of acid into the esophagus.
		An endoscope is a flexible tube that has a light on it, which allows physicians to view internal sections of the body during procedures referred to as "endoscopy" or "endoscopic procedures." The severity of reflux symptoms does not correlate with the degree of inflammation.
	www.healthywomen.org /healthtopics/gastroesophagealrefluxdiseasegerd (1331 words)

	Cardia - Wikipedia, the free encyclopedia
		It has been suggested that this article or section be merged with Lower esophageal sphincter.
		The cardia is also called the Lower esophageal sphincter (LES), cardiac sphincter and gastroesophageal sphincter.
		This one-way valve is called the lower esophageal sphincter (LES), and prevents gastric juice from flowing back into the esophagus.
	en.wikipedia.org /wiki/Cardia (304 words)

	The Longitudinal Muscle in Esophageal Disease - Where Is The Sphincter
		In a sense the sphincter is the stationary end of the peristaltic wave.
		There is no peristalsis in the fundus of the stomach or distal to the sphincter in the.3-3 cm aperistaltic esophageal segment interposed between the sphincter and the fundus.
		3.Wolf, B.S., The inferior esophageal sphincter - roentgenologic and manometric correlation, contradictions and terminology.
	www.mailbag.com /users/oesophagus/webdoc25.htm (1903 words)

	Annual Reviews -- DeMeester et al. ( Medicine 50: 469)
		As sphincter length decreased, the pressure recorded within the sphincter decreased only slightly until a length of 2 cm was reached, when sphincter pressure dropped precipitously and competency of the sphincter was lost.
		Comparison of esophageal bile acid concentration, measured by continuous aspiration, and esophageal acid exposure, measured by the percentage of time that pH is lower than 4, in normal subjects and in patients with mucosal injury of varied severity.
		landmarks that correlate with the lower esophageal high-pressure
	indexmedico.com /ed_prof/edicion5/especialidades/Local/Gastro/469.htm (8517 words)

	Effects of Bronchial Obstruction on Lower Esophageal Sphincter Motility and Gastroesophageal Reflux in Patients with ...
		Effects of Bronchial Obstruction on Lower Esophageal Sphincter Motility and Gastroesophageal Reflux in Patients with Asthma -- Zerbib et al.
		Mechanisms of lower oesophageal sphincter incompetence in patients with symptomatic gastrooesophageal reflux.
		Effect of a catheter in the pharynx on the frequency of transient lower esophageal sphincter relaxations.
	ajrccm.atsjournals.org /cgi/content/full/166/9/1206 (4017 words)

	Causes of GERD
		Some people are born with a naturally weak lower esophageal sphincter (LES).
		It relaxes the lower esophageal sphincter (LES) muscles and, in high amounts, may irritate the mucous membrane of the esophagus.
		A condition in which the cells lining the lower part of the esophagus have changed or been replaced with abnormal cells that could lead to cancer of the esophagus.
	www.nexiumresearch.com /gerd_cause.html (565 words)

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