By Albert J. Bredenoord, André Smout, Jan Tack
This booklet describes the explanations and medical administration of practical gastrointestinal issues in a conveniently comprehensible approach, through many transparent illustrations. The concrete and sensible recommendation supplied may be so much necessary within the medical perform of either the overall practitioner and the clinical professional. useful problems of the gastrointestinal tract, comparable to gastroesophageal reflux disorder, practical dyspepsia, and irritable bowel syndrome, are quite common and persistent stipulations. regardless of the new e-book of many medical papers on their analysis and remedy, a lot is still uncertain, and administration remains to be thought of hard. This practice-oriented ebook can be a great resource of trustworthy up to date information for all who take care of those patients.
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Additional info for A Guide to Gastrointestinal Motility Disorders
3. The UES relaxes and the pharyngeal constrictors contract so the bolus is moved in distal direction. 4. A peristaltic wave starts above the pharynx and moves in distal direction. This will push the bolus through the relaxed UES. The bolus has entered the esophagus and the esophageal swallow phase has been initiated. After the bolus has passed the UES, the sphincter will close. The peristaltic wave initiated by the swallow (primary peristalsis) moves further in distal direction with a propagating velocity of 3–5 cm/s.
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. In the oral phase the swallow is still under voluntary control. This phase starts when the tongue pushes part of the food in the mouth against the palate and moves it toward the back of the mouth.
The muscles of the mouth and tongue push the food to the throat so it can be swallowed. In resting state, the esophagus is empty and the lumen is collapsed. The UES and LES exert a tonic pressure and seal off the esophagus. The onset of a swallow is voluntary, but the rest of the sequence that follows is reflexogenic. Swallowing is a wellorganized movement of the mouth, tongue, throat, esophagus, and sphincters and results in transport of a bolus from the mouth to stomach. The swallow reflex inhibits respiration temporarily so that food does not enter the airways during swallowing.