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June 10, 1968


JAMA. 1968;204(11):999. doi:10.1001/jama.1968.03140240055017

The belief that many chronic disorders of the gastrointestinal system are intimately related to, if not caused by, disordered motility is widely held but rarely documented. Visceral motility is regulated by the activity of the intramural parasympathetic ganglion cells and sympathetic fibers reaching all visceral organs. Certain gastrointestinal motor disorders have an established etiology in lesions of the autonomic nervous system. Classical examples include the aganglionosis of Hirschsprung's disease and the association of enlarged organs in chronic Chagas disease with destruction of intramural ganglion cells by Trypanosoma cruzi. A more complex disease is achalasia or cardiospasm in which pathologic findings have been described in the dorsal motor nucleus and the preganglionic axons of the vagus nerve, as well as a reduction of the number of ganglion cells within the intramural plexi.

Abnormalities of motility of the viscera complicate diabetes mellitus. Clinically observed complications such as diabetic diarrhea, delayed gastric emptying,