Esophageal motility

Esophageal motility is the coordinated physiological process of muscular contractions and relaxations that propel a bolus from the oral cavity to the stomach (StatPearls, NBK537106). It involves the sequential activation of the upper esophageal sphincter, the esophageal body through primary and secondary peristalsis, and the lower esophageal sphincter (LES) (NIH, StatPearls). This process is regulated by the enteric nervous system, the vagus nerve, and various neurotransmitters such as acetylcholine, which mediates contraction, and nitric oxide, which mediates relaxation (PubMed, PMID: 28606528). Disorders of esophageal motility, including achalasia, distal esophageal spasm, and jackhammer esophagus, result from the failure of these coordinated movements, often leading to symptoms like dysphagia and chest pain (Mayo Clinic). While 'esophageal motility' itself is a physiological function rather than a single molecular target, it is the primary therapeutic focus for various drugs that modulate smooth muscle tone and neuronal signaling, such as calcium channel blockers, nitrates, and phosphodiesterase inhibitors (PubMed, PMID: 30214886).

Other names

Esophageal peristalsisEsophageal motor functionDeglutition (esophageal phase)Esophageal transit

Pharmacological modulation of esophageal motility involves the use of calcium channel blockers and nitrates to relax smooth muscle, prokinetic agents (5-HT4 agonists or D2 antagonists) to enhance cholinergic activity, and phosphodiesterase-5 inhibitors to increase nitric oxide-mediated relaxation of the lower esophageal sphincter.