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Normal and abnormal physiology, pharmacology, and anatomy of the gastroesophageal junction high‐pressure zone
Author(s) -
Miller Larry,
Vegesna Anil,
Ruggieri Michael,
Braverman Alan
Publication year - 2016
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.13168
Subject(s) - reflux , esophagus , diaphragm (acoustics) , gastroesophageal junction , medicine , stomach , anatomy , disease , adenocarcinoma , physics , cancer , acoustics , loudspeaker
The high‐pressure zone of the gastroesophageal junction acts as a multifunctional valve that comprises different groups of smooth muscles located in the distal esophagus and the proximal stomach, in addition to the extrinsic crural diaphragm, composed of skeletal muscle. In this review article, we evaluate the current literature with respect to human subjects, discussing the anatomic locations and physiologic and pharmacologic processes controlling these muscles. These muscles work individually and as a group to prevent reflux of gastric contents while allowing anterograde passage of food and liquid and retrograde passage of gas. We also reviewed new findings with respect to abnormalities that are permissive of reflux of gastric contents into the esophagus, which may lead to gastroesophageal reflux disease.