Editorial
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Feb 21, 2008; 14(7): 985-990
Published online Feb 21, 2008. doi: 10.3748/wjg.14.985
Neuro-regulation of lower esophageal sphincter function as treatment for gastroesophageal reflux disease
Anupender Singh Sidhu, George Triadafilopoulos
Anupender Singh Sidhu, George Triadafilopoulos, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94305-5187, United States
Author contributions: Both authors contributed equally to this paper; Sidhu AS has no conflicts to declare; Triadafilopoulos G has equity position with XenoPort.
Correspondence to: George Triadafilopoulos, MD, Clinical Professor of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Always Building, Room M 211, 300 Pasteur Drive, MC: 5187, Stanford, CA 94305-5187, United States. vagt@stanford.edu
Telephone: +1-650-9887488
Fax: +1-650-9887486
Received: December 27, 2007
Revised: January 13, 2008
Published online: February 21, 2008
Abstract

The junction between the esophagus and the stomach is a specialized region, composed of lower esophageal sphincter (LES) and its adjacent anatomical structures, the gastric sling and crural diaphragm. Together these structures work in a coordinated manner to allow ingested food into the stomach while preventing reflux of gastric contents across the esophago-gastric junction (EGJ) into the esophagus. The same zone also permits retrograde passage of air and gastric contents into esophagus during belching and vomiting. The precise coordination required to execute such a complicated task is achieved by a finely-regulated high-pressure zone. This zone keeps the junction between esophagus and stomach continuously closed, but is still able to relax briefly via input from inhibitory neurons that are responsible for its innervation. Alterations of the structure and function of the EGJ and the LES may predispose to gastroesophageal reflux disease (GERD).

Keywords: Gastroesophageal reflux disease; Lower esophageal sphincter; Esophago-gastric junction