Integrity of cholinergic innervation to the lower esophageal sphincter in XXXX .

@entity1 @entity1318 @entity10026 @entity4560 @entity3897 @entity3586 @entity2710
The @entity1 lower esophageal sphincter (LES) is believed to be innervated by nonadrenergic, noncholinergic inhibitory nerves, and cholinergic excitatory nerves. In idiopathic @entity1318 , LES relaxation is abnormal because the inhibitory nerves to the sphincter are either absent or functionally impaired. The integrity of cholinergic excitatory nerves to the LES, however, has not been thoroughly evaluated. In 27 @entity1 with untreated idiopathic @entity1318 , and 21 healthy volunteers, we investigated the hypothesis that postganglionic cholinergic nerves to the LES are functionally intact in @entity1318 . The LES responses to @entity3897 , @entity4560 , @entity2710 , @entity3586 , and @entity10026 were assessed. In 2 @entity1318 @entity1 , patterns of fasting motor activity in the LES were investigated during overnight manometric studies. Resting LES pressure was significantly greater in the @entity1318 @entity1 , 41 +/- 4 mmHg (mean +/- SE), than in the normal subjects, 20 +/- 2 mmHg. @entity3897 significantly reduced LES pressure in both groups by 30%-75%. @entity4560 increased LES pressure in the @entity1318 @entity1 but had negligible effect on the normal subjects. The LES in @entity1318 @entity1 exhibited an increased sensitivity to both @entity2710 and @entity10026 compared with the normal subjects. In both @entity1 who underwent an overnight manometric study, the LES exhibited cyclic phasic contractile activity synchronous with gastric contractions during the migrating motor complex. We conclude that the study findings support the hypothesis that postganglionic cholinergic LES innervation in @entity1318 @entity1 is either normal or only minimally impaired, in contrast to the marked impairment of the inhibitory nerves governing LES relaxation.
