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The Gastro-oesophageal Sphincter

  • Chapter
Alimentary Sphincters and their Disorders

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Abstract

An anti-reflux mechanism is essential at the gastro-oesophageal junction because of the pressure difference between the fundus of the stomach and the body of the oesophagus, which would otherwise force gastric contents, including acid, up into the oesophagus. This mechanism has several components—most of which are anatomical. These include the length of intra-abdominal oesophagus, the right crus of the diaphragm, the gastric sling fibres and the redundant mucosa lining the oesophagogastric junction. In addition, there is now general acceptance that a ‘physiological sphincter’ mechanism separates these two cavities. All of the above are important components of the anti-reflux mechanism but as yet their relative contributions to the competence of the junction are unclear. It is plain, however, that an abnormal anatomical configuration, as shown by the presence of a hiatus hernia radiologically, is not always associated with oesophageal reflux (Price and Castell, 1978).

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References

  • Arndorfer, R. C., Stef, J. J., Dodds, W. J., Linehan, J. H. and Hogan, W. J. (1977). Improved infusion system for intraluminal oesophageal manometry. Gastroenterology, 73, 23–27

    Google Scholar 

  • Atkinson, M. (1976). Disorders of oesophageal motility. Clinics in Gastroenterology, January 1976

    Google Scholar 

  • Atkinson, M., Edwards, D. A. W., Horow, A. J. and Rowlands, E. N. (1957). The oesophago-gastric sphincter in hiatus hernia. Lancet, ii, 1138–1142

    Article  Google Scholar 

  • Atkinson, M. and Van Gelder, A. (1977). Oesophageal intraluminal pH recording in the assessment of gastro-oesophageal reflux and its consequences. Am. J. Dig. Dis., 22, 365

    Article  Google Scholar 

  • Babka, J. C. and Castell, D. O. (1973). On the genesis of heartburn. The effect of specific foods on the lower oesophageal sphincter. Am. J. Dig. Dis., 18, 391–397

    Article  Google Scholar 

  • Babka, J. C., Hage, G. W. and Castell, D. O. (1973). The effect of body position on lower oesophageal sphincter pressure. Am. J. Dig. Dis., 18, 441–442

    Article  Google Scholar 

  • Behar, J. and Biancini, P. (1976). Effect of oral metoclorpramide on gastro-oesophageal reflux in the post cibal state. Gastroenterology, 70, 331

    Google Scholar 

  • Behar, J., Biancini, P. and Kerstein, M. (1976). Mechanism of lower oesophageal sphincter pressure increases in response to gastric pressure increments. Gastroenterology, 70, A-5 863

    Google Scholar 

  • Behar, J. and Kastendieck, J. (1974). Studies on sphincter competence. Gastroenterology, 66, 834A

    Google Scholar 

  • Bernstein, L. M. and Baker, L. A. (1958). A clinical test for oesophagitis. Gastroenterology, 34, 760

    Google Scholar 

  • Biancini, P., Zabinski, M. P. and Behar, J. (1975). Pressure, tension and force of closure of the human lower oesophageal sphincter and oesophagus. J. Clin. Invest., 56 476–483

    Article  Google Scholar 

  • Boesby, S. (1977). Gastro-oesophageal sphincter pressure, motility and acid clearing. Scand. J. Gastroenterol., 12, 407–416

    Article  Google Scholar 

  • Booth, D. J., Kemmerer, W. T. and Skinner, D. B. (1968). Acid clearing from the distal oesophagus. Arch. Surg., 96, 731

    Article  Google Scholar 

  • Brennan, T. G., Trindade, L. M., Rozycki, Z. J. and Giles, G. R. (1974). The influence of lower oesophageal sphincter pressure on the outcome of hiatus hernia repair. Br. J. Surg., 61, 201–205

    Article  Google Scholar 

  • Burnstock, G. (1972). Purinergic nerves. Pharm. Rev., 24, 509–581

    Google Scholar 

  • Cassella, R. R., Ellis, F. H. Jr. and Brown, A. L. (1965). Fine structure changes in achalasia of the oesophagus. 1. Vagus nerves. Am. J. Pathol., 46, 279–288

    Google Scholar 

  • Castell, D. O. and Harris, L. D. (1970). Hormonal control of gastro-oesophageal sphincter strength. New Engl. J. Med., 282, 886–890

    Article  Google Scholar 

  • Christensen, J. and Conklin, J. (1974). Studies on the origin of the distinctive mechanics of smooth muscle at the oesophago-gastric junction. In Proceedings of the IVth International Symposium on Gastro-Intestinal Motility, Mitchell Press, Vancouver, pp. 63–71

    Google Scholar 

  • Christensen, J., Conklin, J. L. and Freeman, B. W. (1973a). Physiological specialisation at the oesophago-gastric junction in the opossum. Am. J. Physiol., 225, 1265–1270

    Google Scholar 

  • Christensen, J., Freeman, B. W. and Miller, J. K. (1973b). Some physiological characteristics of the oesophago-gastric junction in the opossum. Gastroenterology, 64, 1119–1125

    Google Scholar 

  • Code, C. F., Schlegel, J. F., Kelley, M. L. Jr., Olsen, A. M. and Ellis, F. H. (1960). Hypertensive gastro-oesophageal sphincter. Proc. Staff Meetings Mayo Clinic, 35, 391–399

    Google Scholar 

  • Cohen, S. (1974). What is physiological? An answer! Gastroenterology, 66, 497

    Google Scholar 

  • Cohen, S. and Harris, L. (1969). The adaptive response of the lower oesophageal sphincter. Clin. Res., 17, 3000

    Google Scholar 

  • Cohen, S. and Lipshutz, W. (1971a). Hormonal regulation of human lower oesophageal sphincter competence: interaction of gastrin and secretin. J. Clin. Invest., 50, 449–454

    Article  Google Scholar 

  • Cohen, S. and Lipshutz, W. (197lb). Lower oesophageal sphincter dysfunction in achalasia. Gastroenterology, 61, 814

    Google Scholar 

  • Cohen, S., Lipshutz, W. and Hughes, W. (1971). Role of gastrin supersensitivity in the pathogenesis of lower oesophageal sphincter hypertension in achalasia. J. Clin. Invest., 50, 1241

    Article  Google Scholar 

  • Cohen, S. and Snape, W. J. Jr. (1975). Action of metiamide on the lower oesophageal sphincter. Gastroenterology, 69, 911–919

    Google Scholar 

  • Crispin, J. S., McIver, D. K. and Lind, D. F. (1967). Manometric study of the effect of vagotomy on the gastro-oesophageal sphincter. Can. J. Surg., 10, 299–303

    Google Scholar 

  • Csendes, A., Stramszer, T. and Uribe, P. (1975). Alterations in normal oesophageal motility in patients with Chagas’ disease. Am. J. Dig. Dis., 20, 437

    Article  Google Scholar 

  • Davenport, H. W., Warner, H. A. and Code, C. F. (1964). Functional significance of gastric mucosal barrier to sodium. Gastroenterology, 47, 142

    Google Scholar 

  • de Carle, D. J. and Christensen, J. (1976). A dopamine receptor in oesophageal smooth muscle of the opossum. Gastroenterology, 70, 216–219

    Google Scholar 

  • de Moraer-Filho, J. P. P. and Bettarello, A. (1974). Lack of specificity of the acid perfusion test in duodenal ulcer patients. Am. J. Dig. Dis., 19, 785

    Article  Google Scholar 

  • Dent, J. and Chir, B. (1976). A new technique for continuous sphincter pressure measurement. Gastroenterology, 71, 263–267

    Google Scholar 

  • Dernish, G. W. and Castell, D. O. (1971). Inhibitory effect of smoking on the lower oesophageal sphincter. New Engl. J. Med., 284, 1136

    Article  Google Scholar 

  • Diament, N. E. and El-Sharkawy, T. Y. (1977). Neural control of oesophageal peristalsis—a conceptional analysis. Gastroenterology, 72, 546

    Google Scholar 

  • Dilwari, J. B. and Misiewicz, J. J. (1973). Action of metoclorpramide on the gastro-oesophageal junction in man. Gut, 14, 380

    Article  Google Scholar 

  • Dilwari, J. B., Newman, A., Poleo, J. and Misiewicz, J. J. (1973). The effect of prostaglandins and of anti-inflammatory drugs on the oesophagus and the cardiac sphincter in man. Gut, 14, 822

    Google Scholar 

  • DiMarino, A. J. and Cohen, S. (1973). The adrenergic control of lower oesophageal sphincter function. J. Clin. Invest., 52, 2264–2271

    Article  Google Scholar 

  • Dobson, A. (1959). Active transport through the epithelium of the reticulo-rumen sac. J. Physiol., Lond., 146, 235–251

    Article  Google Scholar 

  • Dodds, W. J., Hogan, W. J. and Miller, W. N. (1976). Reflux oesophagitis. Am. J. Dig. Dis., 21, 49

    Article  Google Scholar 

  • Dodds, W. J., Hogan, W. J., Miller, W. N., Barreras, R. F., Arndorfer, R. C. and Stef, J. J. (1975a). Relationship between serum gastrin concentration and lower oesophageal sphincter pressure. Am. J. Dig. Dis., 20, 201–207

    Article  Google Scholar 

  • Dodds, W. J., Hogan, W. J., Miller, W. N., Stef, J. J., Arndorfer, R. C. and Lydon, S. B. (1975b). Effect of increased intra-abdominal pressure on lower oesophageal sphincter pressure. Am. J. Dig. Dis., 20, 298–307

    Article  Google Scholar 

  • Dodds, W. J., Hogan, W. J., Stef, J. J., Miller, W. N., Lydon, S. B. and Arndorfer, R. C. (1975c). A rapid pull-through technique for measuring lower oesophageal sphincter pressure. Gastroenterology, 68, 437–443

    Google Scholar 

  • Donne, A. (1834). Recherches sur quelques unes des proprietes chimiques des secretions et sur les courants electriques qui existent dans les corps organises. Ann. Chim. Phys., 57, 398

    Google Scholar 

  • Donner, M. W., Silbiger, M. L., Hookman, P. and Hendrix, T. R. (1966). Acid barium swallows in the radiographic evaluation of clinical oesophagitis. Radiology, 87, 220–225

    Article  Google Scholar 

  • Earlam, R. J. (1972). Further experience using the epigastric pain reproduction test in duodenal ulceration. Br. Med. J., 1, 683–685

    Article  Google Scholar 

  • Eastwood, G. L., Castell, D. O. and Higgs, R. (1975). Experimental oesophagitis in cats impairs lower oesophageal sphincter pressure. Gastroenterology, 69, 146–153

    Google Scholar 

  • Farrell, R. L., Castell, D. O. and McGuigan, J. E. (1974). Measurements and comparisons of lower oesophageal sphincter pressure and serum gastrin levels in patients with gastro-oesophageal reflux. Gastroenterology, 67, 415–422

    Google Scholar 

  • Farrell, R. L., Roling, G. T. and Castell, D. O. (1973). Stimulation of the incompetent lower oesophageal sphincter. A possible advance in the therapy of heartburn. Am. J. Dig. Dis., 18, 646

    Article  Google Scholar 

  • Fisher, R. S., Malmud, L. S., Roberts, G. S. and Lobis, I. F. (1976). Gastro-oesophageal scintiscanning to detect and quantitate gastro-oesophageal reflux. Gastroenterology, 70, 301

    Google Scholar 

  • Fisher, R. S., Malmud, L. S., Roberts, G. S. and Lobis, I. F. (1977). The lower oesophageal sphincter as a barrier to gastro-oesophageal reflux. Gastroenterology, 72, 19–22

    Google Scholar 

  • Freeland, G. R., Higgs, R. H. and Castell, D. O. (1977). Lower oesophageal sphincter responses to oral administration of cimetidine in normal subjects. Gastroenterology, 72, 28–30

    Google Scholar 

  • Fyke, F. E., Code, C. F. and Schlegel, J. F. (1956). The gastro-oesophageal sphincter in healthy human beings. Gastroenterologie (Basel), 86, 135

    Article  Google Scholar 

  • Garrett, J. M. and Goodwin, D. H. (1969). Gastro-oesophageal hypercontracting sphincter. J. Am. Med. Assoc., 208, 992–998

    Article  Google Scholar 

  • Geall, M. G., Code, C. F., Mcllrath, D. C. and Summerskill, W. H. J. (1970). Measurement of gastrointestinal transmural electric potential difference in man. Gut, 11, 34–37

    Article  Google Scholar 

  • Gibbs, D. (1976). Endoscopy in the assessment of reflux oesophagitis. In Clinics in Gastroenterology. Disorders of Oesophageal Motility (ed. Michael Atkinson ), January, 1976

    Google Scholar 

  • Giles, G. R., Mason, M. C., Humphries, C. and Clark, C. G. (1969). Action of gastrin on lower oesophageal sphincter in man. Gut, 10, 730–734

    Article  Google Scholar 

  • Goodal, R. J. R., Hay, D. J. and Temple, J. G. (1980). Assessment of the rapid pullthrough technique in oesophageal manometry. Gut, 21, 169–173

    Article  Google Scholar 

  • Goyal, R. K. and McGuigan, J. E. (1975). Failure of gastrin antiserum to influence lower oesophago-sphincter pressure: a double blind controlled study. Gastroenterology, 68, 951

    Google Scholar 

  • Goyal, R. K. and Rattan, S. (1975). Nature of the vagal inhibitory innervation of the lower oesophageal sphincter. J. Clin. Invest., 55, 1119–1126

    Article  Google Scholar 

  • Goyal, R. K. and Rattan, S. (1978). Neurohumural, hormonal and drug receptors for the lower oesophageal sphincter. Gastroenterology, 74, 598–619

    Google Scholar 

  • Grantham, R. N., Code, C. F. and Schlegel, J. F. (1970). Reference electrode sites in determination of potential differences across the gastro-oesophageal muscular junction. Mayo Clin. Proc., 45, 265–274

    Google Scholar 

  • Grossman, M. I. (1973). What is physiological? Gastroenterology, 65, 994

    Google Scholar 

  • Habibulla, K. S. (1972). The diaphragm as an anti-reflux barrier. A manometric, oesophagoscopic and transmucosal potential study. Thorax, 27, 692–702

    Article  Google Scholar 

  • Harris, L. D., Winans, C. S. and Pope, C. II (1966). Determination of yield pressures: a method for measuring anal sphincter competence. Gastroenterology, 50, 754–760

    Google Scholar 

  • Harrison, G. K. (1969). Oesophageal muscle changes in achalasia. Lancet, i, 530

    Article  Google Scholar 

  • Helm, W. J., Schlegel, J. F., Code, C. F. and Summerskill, W. H. J. (1965). Identification of the gastro-oesophageal mucosal junction by transmucosal potential in healthy subjects and patients with hiata hernia. Gastroenterology, 48, 23–25

    Google Scholar 

  • Higgs, R. H., Smith, R. D. and Castell, D. O. (1974). Gastric alkalinisation. Effect on lower oesophageal sphincter pressure and serum gastrin. New Engl. J. Med., 291, 486–490

    Article  Google Scholar 

  • Hogben, C. A. M. (1955). Active transport of chloride by isolated frog gastric epithelium: origin of the gastric mucosal potential. Am. J. Physiol., 180, 641–649

    Google Scholar 

  • Hollis, J. B. and Castell, D. O. (1972). Amplitude of oesophageal peristalsis as determined by rapid infusion. Gastroenterology, 63, 417–422

    Google Scholar 

  • Holly, E. (1977). Pressure pH measurement in the human gastro-oesophageal sphincter: A computer analysis. Ph.D. Thesis, University of London

    Google Scholar 

  • Humphries, T. J. and Castell, D. O. (1977). Pressure profile of oesophageal peristalsis in normal humans as measured by direct intra-oesophageal transducers. Am. J. Dig. Dis., 22, 641

    Article  Google Scholar 

  • Ingelfinger, F. J. (1958). Oesophageal motility. Phys. Rev., 38, 533–584

    Google Scholar 

  • Itoh, Z., Honda, R., Aizawa, I., Takeuchi, S., Hiwatashi, K. and Couch, E. F. (1978). Interdigestive motor activity of the lower oesophageal sphincter in the conscious dog. Am. J. Dig. Dis., 23, 239–247

    Article  Google Scholar 

  • Jennewein, H. M., Waldeck, F., Siewert, R., Weiser, F. and Thimm, R. (1973). The interaction of glucagon and pentagastrin on the lower oesophageal sphincter in man and dog. Gut, 14, 861–864

    Article  Google Scholar 

  • Jensen, D. M., Mccallum, R. W. and Walsh, J. H. (1977a). Human lower oesophageal sphincter response to submaximal and maximal effective doses of synthetic human gastrin 1 (G17) is not inhibited by atropine. Gastroenterology, A-15, Abstract 58

    Google Scholar 

  • Jensen, D. M., McCallum, R. W. and Walsh, J. H. (1977b). Human lower oesophageal sphincter response to submaximal and maximal effective doses of synthetic human big gastrin (G34) and gastrin (G17). Gastroenterology, A-61, Abstract 244

    Google Scholar 

  • Johnson, L. F. and Demester, T. R. (1974), Advantages of distal oesophageal 24 hour pH monitoring over other tests for gastro-oesophageal reflux. Gastroenterology, 66, 716

    Google Scholar 

  • Johnson, L. F., Demester, T. R. and Haggitt, R. G. (1974). Oesophageal histology correlated to objective measurements of gastro-oesophageal reflux. Gastroenterology, 66, 717

    Google Scholar 

  • Kantrowitz, P. A., Siegel, C. I. and Hendrix, T. R. (1966). Differences in motility of the upper and lower oesophagus in man and its alteration of atropine. Bull. Johns Hopkins Hosp., 118, 476

    Google Scholar 

  • Kaye, M. D. and Showalter, J. P. (1971). Manometric configuration of the lower oesophageal sphincter in normal human subjects. Gastroenterology, 61, 213

    Google Scholar 

  • Kaye, M. D. and Showalter, J. P. (1974). Measurement of pressure in lower oesophageal sphincter—the influence of catheter diameter. Am. J. Dig. Dis., 19, 860–863

    Article  Google Scholar 

  • Kline, M. M., McCallum, R. W., Curry, N. and Sturdevant, R. A. L. (1975). Effect of gastric alkalinisation on lower oesophageal sphincter pressure on serum gastrin. Gastroenterology, 68, 1137–1139

    Google Scholar 

  • Koelz, H. R., Hollinger, A. P., Sauberli, H., Largiader, F., Siewart, R. and Blum, A. L. (1978). Effect of gastric antrum on regulation of lower oesophageal sphincter pressure in the dog. Am. J. Physiol., 234 (2), E157 – E161

    Google Scholar 

  • Krawitz, J. J., Snape, W. J. Jr. and Cohen, S. (1977). Role of histaminergic receptors in the control of lower oesophageal function. Gastroenterology, A59, Abstract 237

    Google Scholar 

  • Lind, J. F., Cotton, D. J., Blanchard, R., Crispin, J. S. and Dimopolo, S. (1969). Effect of thoracic displacement and vagotomy on the canine gastro-oesophageal junction. Gastroenterology, 56, 1078–1085

    Google Scholar 

  • Lind, J. F., Warrian, W. G. and Wankling, W. J. (1966). Responses of the gastro-oesophageal junctional zone to increases in abdominal pressure. Can. J. Surg., 9, 32–38

    Google Scholar 

  • Lipshutz, W. and Cohen, S. (1971). Physiological determinants of lower oesophageal sphincter function. Gastroenterology, 61, 16–24

    Google Scholar 

  • Lipshutz, W., Hughes, W. and Cohen, S. (1972). The genesis of the lower oesophageal sphincter pressure; its identification through the use of gastrin antiserum. J. Clin. Invest., 51, 522–529

    Article  Google Scholar 

  • Lipshutz, W., Tuch, A. F. and Cohen, S. (1971). A comparison of the site of action of gastrin 1 on lower oesophageal sphincter and antral circular smooth muscle. Gastroenterology, 61, 454–460

    Google Scholar 

  • Lyndon, S. B., Dodds, W. J., Hogan, W. J. and Arndorfer, R. C. (1975). The effect of manometric assembly diameter on intraluminal oesophageal pressure recording. Am. J. Dig. Dis., 20, 968–970

    Article  Google Scholar 

  • Mann, C. V., Greenwood, R. K. and Ellis, F.H. Jr. (1964). The oesophago-gastric junction. Surg., Gynec. Obst., 118, 853–862

    Google Scholar 

  • Mann, C. V. and Shorter, R. G. (1964). Structure of the canine oesophagus and its sphincter. J. Surg. Res., IV, 160–163

    Article  Google Scholar 

  • Meckeler, K. J. and Ingelfinger, F. J. (1967). Correlation of electric surface potentials, intraluminal pressure and nature of tissue in the gastro-oesophageal junction of man. Gastroenterology, 52, 966–971

    Google Scholar 

  • Mei, N., Salducci, J. and Monges, H. (1972). Afferent vagal impulses from the lower oesophageal sphincter of the cat. Rend. Gastroenterol., 4, 65–68

    Google Scholar 

  • Meltzer, S. J. (1899). On the causes of the orderly progress of the peristaltic movements in the oesophagus. Am. J. Physiol., 2, 266–272

    Google Scholar 

  • Miller, W. N., Graneshapper, W. J., Dodds, W. J., Hogan, W. J., Arndorfer, R. C. and Stef, J. J. (1974). Preliminary report on Millhon-Crites intra-oesophageal motility probe. Am. J. Dig. Dis., 13, 929–933

    Google Scholar 

  • Millhon, W. A., Hoffman, D. E. and Jarvis, P. (1968). Preliminary report on Millhon-Crites intraoesophageal motility probe. Am. J. Dig. Dis., 13, 929–933

    Article  Google Scholar 

  • Miolan, J. P. and Roman, C. (1973). Activity of vagal efferent fibres innervating the dog’s cardia. J. Physiol. (Paris), 66, 171–198

    Google Scholar 

  • Nebel, O. T. and Castell, D. O. (1972). Lower oesophageal sphincter pressure changes after food ingestion. Gastroenterology, 63, 778

    Google Scholar 

  • Olsen, A. M. and Schlegel, J. F. (1965). Motility disturbances caused by oesophagitis. J. Thorac. Cardiovasc. Surg., 50, 607–612

    Google Scholar 

  • Pope, C. E. II (1967). A dynamic test of sphincter strength: its application to the lower oesophageal sphincter. Gastroenterology, 52, 779–786

    Google Scholar 

  • Pope, C. E. II (1976). Pathophysiology and diagnosis of reflux oesophagitis. Gastroenterology, 70, 445

    Google Scholar 

  • Price, S. and Castell, D. O. (1978). Oesophageal mythology. J. Am. Med. Assoc., 240, 44

    Article  Google Scholar 

  • Rattan, S. and Goyal, R. K. (1974). Neural control of lower oesophageal sphincter: influence of vagus nerves. J. Clin. Invest., 54, 899–906

    Article  Google Scholar 

  • Rattan, S. and Goyal, R. K. (1976). Effect of dopamine on the oesophageal smooth muscle in vivo: evidence of excitatory and inhibitory dopamine receptors. Gastroenterology, 70, 377–381

    Google Scholar 

  • Rehm, W. S. (1946). Evidence that the major portion of the gastric potential originates between the submucosa and mucosa. Am. J. Physiol., 147, 69

    Google Scholar 

  • Resin, H., Stern, D. H., Sturdevant, R. A. C. and Isenberg, J. I. (1973). Effect of C-terminal octapeptide of CCK on lower oesophageal sphincter pressure in man. Gastroenterology, 64, 946–949

    Google Scholar 

  • Siegel, C. I. and Hendricks, J. R. (1963). Oesophageal motor abnormalities induced by acid perfusion in patients with heartburn. J. Clin. Invest., 42, 686–695

    Article  Google Scholar 

  • Siewart, R., Weiser, F. and Jennewein, H. M. (1974). Clinical and manometric investigation of the lower oesophageal sphincter and its reactivity to pentagastrin in patients with hiatus hernia. Digestion, 10, 287–297

    Article  Google Scholar 

  • Smith, B. (1970). The neurological tension in achalasia of the cardia. Gut, 11, 388–391

    Article  Google Scholar 

  • Stanciu, C. and Bennett, J. R. (1972). The effect of smoking on gastro-oesophageal reflux. Gut, 13, 318

    Article  Google Scholar 

  • Stanciu, C. and Bennett, J. R. (1973). Metoclorpramide in gastro-oesophageal reflux. Gut, 14, 275

    Article  Google Scholar 

  • Stef, J. J., Dodds, W. J., Hogan, W. I., Linehan, H. J. and Stewart, E. T. (1974). Intraluminal oesophageal manometry. An analysis of variables affecting recording fidelity of peristaltic pressures. Gastroenterology, 67, 227–230

    Google Scholar 

  • Thomas, P. A. (1977). The action of some gastrointestinal polypeptide hormones on the isolated perfused canine gastro-oesophageal sphincter. M.S. Thesis, University of London

    Google Scholar 

  • Thompson, H. (1976). Pathology of reflux oesophagitis. In Clinics in Gastroenterology. Diseases of Oesophageal Motility (ed. Michael Atkinson ), January 1976

    Google Scholar 

  • Tuch, A. and Cohen, S. (1973). Lower oesophageal sphincter relaxation: studies on the neurogenic inhibitory mechanism. J. Clin. Invest., 52, 14–20

    Article  Google Scholar 

  • Turnen, H. J., Stein, G. N. and Shlansky, F. (1960). X-Ray and clinical features of hiatal hernia—significance of hiatal hernia of minimal degree. Gastroenterology, 38, 873

    Google Scholar 

  • Tuttle, S. G., Betarello, A. and Grossman, M. I. (1960). Oesophageal acid perfusion test and a gastro-oesophageal reflux test in patients with oesophagitis. Gastroenterology, 38, 861

    Google Scholar 

  • Tuttle, S. G., Betarello, A. and Grossman, M. I. (1961). Gastro-oesophageal regurgitation. J. Am. Med. Assoc., 176, 498–500

    Article  Google Scholar 

  • Tuttle, S. G. and Grossman, M. I. (1958). Detection of gastro-oesophageal reflux by simultaneous measurement of intraluminal pressure and pH. Proc. Soc. Expl Biol. Med., 98, 225

    Article  Google Scholar 

  • Wankling, W. J., Warrian, W. G. and Lind, J. F. (1965). The gastro-oesophageal sphincter in hiatus hernia. Can. J. Surg., 8, 61–67

    Google Scholar 

  • Winans, C. (1977). Manometric asymmetry of lower oesophageal high pressure zone. Am. J. Dig. Dis., 22, 348

    Article  Google Scholar 

  • Winans, C. S. and Harris, L. D. (1967). Quantitation of lower oesophageal sphincter competence. Gastroenterology, 52, 773–778

    Google Scholar 

  • Wingate, D. L. (1976). The eupeptide system: a general theory of gastrointestinal hormones. Lancet, i, 529

    Article  Google Scholar 

  • Wright, L. F., Slaughter, R. L., Gibson, R. G. and Hirschowitz, B. I. (1975). Correlation of lower oesophageal sphincter pressure and serum gastrin levels in man. Am. J. Dig. Dis., 20, 603–606

    Article  Google Scholar 

  • Zboralske, F. F. and Dodds, W. J. (1969). Roentgenographic diagnosis of primary disorders of oesophageal motility. Radiol. Clin. North Am., 7, 147–162

    Google Scholar 

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  1. Paul A. Thomas
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Editors and Affiliations

  1. The London Hospital, E1 1BB, London, UK

    Paul A. Thomas (Senior Lecturer and Consultant Surgeon) (Senior Lecturer and Consultant Surgeon)

  2. The London and St Mark’s Hospitals, London, UK

    Charles V. Mann (Consultant Surgeon) (Consultant Surgeon)

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© 1981 Paul A. Thomas and Charles V. Mann

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Thomas, P.A. (1981). The Gastro-oesophageal Sphincter. In: Thomas, P.A., Mann, C.V. (eds) Alimentary Sphincters and their Disorders. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-03940-1_4

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  • DOI: https://doi.org/10.1007/978-1-349-03940-1_4

  • Publisher Name: Palgrave Macmillan, London

  • Print ISBN: 978-1-349-03942-5

  • Online ISBN: 978-1-349-03940-1

  • eBook Packages: MedicineMedicine (R0)

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