Nascent esophagus, sensory-motor physiology during maturation

Abstract

The incidence of feeding and airway-related disorders is high, particularly among those neonates that graduate from the intensive care units. Commonly noted neonatal feeding problems that are influenced by esophageal anatomical and pathophysiological considerations include swallowing disorders, gastroesophageal reflux disease, aspiration syndromes, congenital foregut anomalies, and chronic lung disease. The functions of esophagus can be classified into (1) deglutitive peristaltic functions and (2) esophageal protective functions. In contrast to what is known in adult human or animal models, unfortunately, not much is known about these functions relevant to the nascent esophagus. In this chapter, we will explain the developmental physiology of (1) esophageal motility and peristalsis, and (2) sensorymotor aspects of upper esophageal sphincter, lower esophageal sphincter and esophageal body protective reflexes. This chapter follows the pharyngeal functions in relation to deglutition, and therefore the reader should also refer to the former chapter for better understanding of embryology and anatomical considerations.