title: Physiology of the upper segment, body, and lower segment of the esophagus.
abstract: The following discussion on the physiology of the esophagus includes commentaries on the function of the muscularis mucosa and submucosa as a mechanical antireflux barrier in the esophagus; the different mechanisms of neurological control in the esophageal striated and smooth muscle; new insights from animal models into the neurotransmitters mediating lower esophageal sphincter (LES) relaxation, peristalsis in the esophageal body (EB), and motility of esophageal smooth muscle; differentiation between in vitro properties of the lower esophageal circular muscle, clasp muscle, and sling fibers; alterations in the relationship between pharyngeal contraction and relaxation of the upper esophageal sphincter (UES) in patients with dysphagia; the mechanical relationships between anterior hyoid movement, the extent of upper esophageal opening, and aspiration; the application of fluoroscopy and manometry with biomechanics to define the stages of UES opening; and nonpharmacological approaches to alter the gastroesophageal junction (GEJ).
authors.affiliation: North Shore Long Island Jewish Medical Center, New Hyde Park, New York.
authors.forename: Larry
authors.initials: L
authors.lastname: Miller
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain.|Laboratori de Fisiologia Digestiva, Hospital de Mataró, Mataró, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Clavé
authors.affiliation: Center for Gastroenterological Research, Catholic University, Leuven, Belgium.
authors.forename: Ricard
authors.initials: R
authors.lastname: Farré
authors.affiliation: Laboratori de Fisiologia Digestiva, Hospital de Mataró, Mataró, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Lecea
authors.affiliation: Department of Anatomy and Cell Biology, Temple University, Philadelphia, Pennsylvania.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Ruggieri
authors.affiliation: Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Ann
authors.initials: A
authors.lastname: Ouyang
authors.affiliation: Trinity Academic Gastroenterology Group, Tallaght Hospital, Dublin, Ireland.
authors.forename: Julie
authors.initials: J
authors.lastname: Regan
authors.affiliation: Trinity Academic Gastroenterology Group, Tallaght Hospital, Dublin, Ireland.
authors.forename: Barry P
authors.initials: BP
authors.lastname: McMahon
mesh_terms: D004943:Esophagogastric Junction / Q000502:physiology*; D004947:Esophagus / Q000502:physiology*; D006801:Humans; D009092:Mucous Membrane / Q000502:physiology; D009130:Muscle, Smooth / Q000502:physiology*; D010528:Peristalsis / Q000502:physiology*
keywords: GERD; esophagus; lower esophageal segment; muscularis mucosa; smooth muscle; submucosa; upper esophageal segment