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Esophageal Disorders and Their Relationship to Psychiatric Disease
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Laurence A. Bradley, Joel E. Richter
The physiological mechanisms underlying globus sensation are unknown. It has been suggested that spasm of the upper-esophageal sphincter (UES) might account for globus, but empirical studies have produced conflicting results (31,32). It also has been suggested that globus is associated with hiatal hernia or reflux esophagitis. Wilson and colleagues (33) reported that abnormal gastroesophageal reflux occurred in 37 of 142 (23%) of globus patients. This indicates that, although reflux may be associated with globus sensation, it probably does not contribute to globus sensation in most patients with this symptom.
Digestive and Metabolic Actions of Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
The esophagus is a muscular tube with sphincters at both ends that leads from the pharynx to the stomach (Figure 8.2A). The upper esophageal sphincter (UES) is under conscious control and its main function is to keep food from going down the larynx during breathing, eating, belching, and vomiting. The lower esophageal sphincter (LES) is not under voluntary control and acts to prevent acid and stomach contents from moving backward into the mouth. Propulsion of food through the esophagus occurs through peristalsis, with a contraction occurring behind a bolus of food and a relaxation occurring ahead of the bolus of food (Figure 8.2B).
Introduction
Published in Shayne C. Gad, Toxicology of the Gastrointestinal Tract, 2018
The esophagus secretes mucus and transports food into the stomach. It does not produce digestive enzymes, and it does not carry on absorption. The passage of food from the laryngopharynx into the esophagus is regulated at the entrance to the esophagus by a sphincter (a circular band or ring of muscle that is normally contracted) called the upper esophageal sphincter. It consists of the cricopharyngeus muscle attached to the cricoid cartilage. The elevation of the larynx during the pharyngeal stage of swallowing causes the sphincter to relax, and the bolus enters the esophagus. This sphincter also relaxes during exhalation.
Current status and advances in esophageal drug delivery technology: influence of physiological, pathophysiological and pharmaceutical factors
Published in Drug Delivery, 2023
Ai Wei Lim, Nicholas J. Talley, Marjorie M. Walker, Gert Storm, Susan Hua
The esophagus is a part of the gastrointestinal tract (GI tract) that connects the pharynx to the stomach. It is a hollow, muscular channel that delivers swallowed food bolus to the stomach. The thickness of the esophageal wall in healthy individuals varies depending on the section of the esophagus, with the largest wall thickness during esophageal contraction of 4.70 mm (95%CI: 4.44-4.95) and during esophageal dilation of 2.11 mm (95%CI: 2.00-2.23) (Xia et al., 2009). The esophagus begins at the upper esophageal sphincter that is formed by the cricopharyngeal muscle and ends with the lower esophageal sphincter, which is surrounded by the crural diaphragm (Standring, 2020). While the average length of the esophagus in an adult is between 23 to 25 cm, the length in children at birth varies between 8 to 10 cm (Standring, 2020; Scott-Brown et al., 2008). The esophagus is lined with non-keratinized squamous epithelium in humans and the muscular elements are smooth muscle (Standring, 2020).
Correlation between dysphonia and dysphagia evolution in amyotrophic lateral sclerosis patients
Published in Logopedics Phoniatrics Vocology, 2021
Chiara Mezzedimi, Enza Vinci, Fabio Giannini, Serena Cocca
Phonation induces a significant increase in upper esophageal sphincter (UES) pressure. This UES pressure increase is significantly higher than that of the stomach, esophagus, and lower esophageal sphincter (LES), indicating the existence of a phonation-induced UES contractile reflex. The UES pressure generated by activation of this reflex is influenced by sex [19]. The upper esophageal sphincter is comprised of the cricopharyngeal muscles (CPM), inferior pharyngeal constrictor, and the proximal cervical esophagus. CPM is controlled by medulla, thus medullary infarction may result in a failed relaxation of UES. According to Kang SH et al. [20], the occurrence of the upper esophageal sphincter (UES) dysfuction might be the first step, which in turns affect the swallowing process, resulting in pharyngo-esophageal dyssynergia, and so dysphagia.
Zenker’s diverticulum treated via per-oral endoscopic myotomy
Published in Baylor University Medical Center Proceedings, 2020
Ahmed Ebrahim, Steven G. Leeds, Jessica S. Clothier, Marc A. Ward
The cricopharyngeus muscle is the major component of the upper esophageal sphincter.2 Cricopharyngeal dysfunction can lead to a range of disorders, from mild halitosis to dysphagia and aspiration. Common complications of open myotomy in the treatment of ZD include fistula formation and recurrent nerve injury. Patients with ZD also tend to be elderly and may have medical comorbidities that preclude open surgery. Balloon dilation for symptomatic treatment of these patients has been trialed, though with limited success.3 Another common approach is known as trans-oral stapled diverticulectomy. This has the drawbacks of poor visualization due to the large size of the stapler relative to the oral cavity, which can result in a residual pouch due to poor technique. Endoscopic cricopharyngeal myotomy offers lower rates of mortality and complications in the treatment of ZD. In conclusion, Z-POEM is an efficacious first-line treatment for ZD.