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May 1976

Mucosal Response to Esophageal Motor Disorders

Author Affiliations

From the Veterans Administration Hospital and the Department of Medicine, University of Washington Medical School, Seattle, Wash.

Arch Intern Med. 1976;136(5):549-555. doi:10.1001/archinte.1976.03630050037008

The mucosa of the esophagus is involved in only one disorder of motor function, lower esophageal sphincter (LES) incompetence. Although long-standing megaesophagus in untreated achalasia used to be associated with inflammation, leukoplakia, and carcinomatous degeneration,1,2 modern treatment has made such mucosal changes distinctly more uncommon. This communication, therefore, discusses changes in the esophageal mucosa brought about by reflux of gastrointestinal contents into the esophagus through an incompetent LES.

METHODS OF MUCOSAL EVALUATION  Several different methods of studying the esophageal mucosa are available, both clinically and experimentally. Roentgenographic contrast study of the mucosa during a barium swallow certainly is the most common form of investigation employed clinically, but unfortunately it is one of the least sensitive. Unless mucosal damage has progressed to deep ulceration or stricture formation, the barium examination of the esophageal mucosa will usually be reported as normal.3 This is not surprising, since primary mucosal diseases in

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