Skip to main content
Gut logoLink to Gut
. 1972 Jul;13(7):556–558. doi: 10.1136/gut.13.7.556

The site of denervation in achalasia

Sidney Cohen, Robert Fisher, Arthur Tuch
PMCID: PMC1412277  PMID: 5069732

Abstract

Lower oesophageal sphincter supersensitivity to gastrin I and cholinergic stimulation has recently been described in patients with achalasia. To determine the pathogenesis of this finding, the lower oesophageal sphincter was tested to a cholinesterase inhibitor, edrophonium chloride. Edrophonium chloride significantly increased the lower oesophageal sphincter pressure both in normal subjects and in patients with achalasia. The preservation of this response in the presence of denervation supersensitivity suggested intact postganglionic cholinergic nerves and, thus, a preganglionic site of denervation in achalasia.

Full text

PDF
556

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson H. K. The paralysis of involuntary muscle: Part III. On the action of pilocarpine, physostigmine, and atropine upon the paralysed iris. J Physiol. 1905 Dec 30;33(4-5):414–438. doi: 10.1113/jphysiol.1905.sp001129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BURN J. H. Acetylcholine as a local hormone for ciliary movement and the heart. Pharmacol Rev. 1954 Mar;6(1):107–112. [PubMed] [Google Scholar]
  3. CASSELLA R. R., BROWN A. L., Jr, SAYRE G. P., ELLIS F. H., Jr ACHALASIA OF THE ESOPHAGUS: PATHOLOGIC AND ETIOLOGIC CONSIDERATIONS. Ann Surg. 1964 Sep;160:474–487. doi: 10.1097/00000658-196409000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cohen S., Lipshutz W., Hughes W. Role of gastrin supersensitivity in the pathogenesis of lower esophageal sphincter hypertension in achalasia. J Clin Invest. 1971 Jun;50(6):1241–1247. doi: 10.1172/JCI106601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Lipshutz W., Tuch A. F., Cohen S. A comparison of the site of action of gastrin I on lower esophageal sphincter and antral circular smooth muscle. Gastroenterology. 1971 Oct;61(4):454–460. [PubMed] [Google Scholar]
  6. Misiewicz J. J., Waller S. L., Anthony P. P., Gummer J. W. Achalasia of the cardia: pharmacology and histopathology of isolated cardiac sphincteric muscle from patients with and without achalasia. Q J Med. 1969 Jan;38(149):17–30. [PubMed] [Google Scholar]
  7. TROUNCE J. R., DEUCHAR D. C., KAUNTZE R., THOMAS G. A. Studies in achalasia of the cardia. Q J Med. 1957 Oct;26(104):433–443. [PubMed] [Google Scholar]
  8. Trendelenburg U. Mechanisms of supersensitivity and subsensitivity to sympathomimetic amines. Pharmacol Rev. 1966 Mar;18(1):629–640. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES