By Albert J. Bredenoord, André Smout, Jan Tack
This publication describes the factors and medical administration of practical gastrointestinal problems in a comfortably comprehensible means, by means of many transparent illustrations. The concrete and sensible suggestion supplied may be such a lot precious within the scientific perform of either the overall practitioner and the scientific expert. sensible issues of the gastrointestinal tract, equivalent to gastroesophageal reflux sickness, useful dyspepsia, and irritable bowel syndrome, are quite common and protracted stipulations. regardless of the new e-book of many medical papers on their analysis and therapy, a lot continues to be uncertain, and administration continues to be thought of difficult. This practice-oriented e-book can be an awesome resource of trustworthy updated advice for all who deal with those patients.
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Extra info for A Guide to Gastrointestinal Motility Disorders
1 Direct Inhibition of Smooth Muscle Contractions of gastrointestinal smooth muscle require a rise of intracellular calcium. Hence, inhibition of calcium channels can be applied to inhibit contractility. This can be achieved through the use of L-type calcium channel blockers, such as nifedipine, amlodipine, or verapamil. However, these agents lack gastrointestinal specificity, and at doses that inhibit gastrointestinal contractility, often side effects occur due to vasodilation (such as low blood pressure, hot flushes, pounding headaches, and edema).
The swallow reflex starts when pressure sensors in the pharynx are stimulated. This activates an afferent nerve to the swallow center in brainstem. From there, motor neurons of the cranial nerves are activated that control the muscles of pharynx and upper esophagus (glossopharyngeal, vagal, and hypoglossal nerves) and the motor neurons of the vagus nerve that control the middle and distal esophagus. J. 1007/978-3-319-26938-2_4 39 4 40 The Esophagus Fig. 1 Schematic display of the anatomy of the esophagus (Published with kind permission of © Rogier Trompert Medical Art 2015) Pharynx Upper esophageal sphincter Esophageal body Lower esophageal sphincter Diaphragm Z-line Stomach A swallow can be divided into three phases, which are the oral phase, the pharyngeal phase, and the esophageal phase.
Pain can be caused by a bolus that gets stuck and stretches the esophageal wall or because spastic contractions are induced. This symptom is also known as odynophagia. Of course, dysphagia can also be caused by narrowing of the esophagus, such as occurs with a tumor or peptic stricture after long-standing reflux disease. In case of esophageal motility disorders, there is often esophageal dysphagia for both solid and liquid foods, while in case of obstructive disorders, there is often dysphagia for solids only.
A Guide to Gastrointestinal Motility Disorders by Albert J. Bredenoord, André Smout, Jan Tack