Gastroenterology Clinics of North America pptx

[...]... disorders: neonate/toddler Gastroenterology 2006;130(5):1519–26 Gastroenterol Clin N Am 36 (2007) 499–513 GASTROENTEROLOGY CLINICS OF NORTH AMERICA Evolving Concepts in the Cellular Control of Gastrointestinal Motility: Neurogastroenterology and Enteric Sciences Amelia Mazzone, PhDa,b, Gianrico Farrugia, MDa,b,* a Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First... involved in the modulation of intestinal functions The study of the complex interaction of different kind of cells is known as ‘‘neurogastroenterology,’’ a subspecialty of gastroenterology that focuses on understanding the control of the sensory and motor function of the gastrointestinal tract in health and disease ENTERIC NERVOUS SYSTEM The enteric nervous system (ENS) regulates most of the physiologic and... Clin N Am 36 (2007) 515–529 GASTROENTEROLOGY CLINICS OF NORTH AMERICA The Gastrointestinal Motility Laboratory Henry P Parkman, MDa,*, William C Orr, PhDb a Gastroenterology Section, Department of Medicine, Temple University School of Medicine, Parkinson Pavilion, 8th Floor, 3401 North Broad Street, Philadelphia, PA 19140, USA b Lynn Health Science Institute, University of Oklahoma Health Sciences... progression of the activity front is a result of sequential activation of a specialized class of descending interneurons Following the ingestion of a meal, the MMC is replaced by an irregular activity, similar to phase II, which in humans lasts for 1 to 2 hours CONCEPTS IN THE CELLULAR CONTROL OF GI MOTILITY 503 Colon motility is irregular and complex and the neuronal control of colonic patterns of motility... immune cells The result of these interactions is effective coordination of motility, secretion, and blood flow in the gastrointestinal tract Much progress has been made in recent years on the understanding of these complex interacting networks Loss of subsets of enteric nerves, loss of ICC, malfunction of smooth muscle, and alteration in immune cells have been identified as the basis of many motility disorders... neurons Activation of excitatory motor neurons above the bolus results in contraction of smooth muscle above the bolus Activation of inhibitory motor neurons results in relaxation of smooth muscle below the bolus Shortening of the muscle immediately below the bolus also occurs as a result of descending excitation [14] The rhythmicity of peristalsis is determined by the electrical activity of the ICC Peristalsis... motility laboratory is poised to grow as the level of diagnostic sophistication in gastroenterology continues to advance The recent analysis of the future practice of gastroenterology suggests that disorders of GI motility and functional GI disorders will comprise a larger percentage of the GI practice in the future, further increasing the importance of the GI motility laboratory [8] THE GASTROINTESTINAL... Innervation of smooth muscle cells Two mechanisms for neuronal innervation of gastrointestinal smooth muscle exist Most innervation occurs through interstitial cells of Cajal Neurons can also directly innervate intestinal smooth muscle cells ICC, interstitial cells of Cajal CONCEPTS IN THE CELLULAR CONTROL OF GI MOTILITY 507 there is also a population of ICC located at the submucosal surface of the circular... FARRUGIA population of intestinofugal neurons receives information arising from other enteric neurons [13] MOTOR PATTERNS Coordinated activation of enteric neuronal circuits is responsible for the rhythmic and regular contraction of the gastrointestinal muscle and the aboral transport of the luminal content Control of gastrointestinal motor function requires the coordinated function of several cell types... population: overlap and lack of stability over time Gastroenterology 1995;109(3): 671–80 [14] Drossman DA, Li Z, Andruzzi E, et al US householder survey of functional gastrointestinal disorders: prevalence, sociodemography, and health impact Dig Dis Sci 1993;38: 1569–80 [15] Locke GR III The epidemiology of functional gastrointestinal disorders in North America Gastroenterol Clin North Am 1996;25:1–19 [16] . gastro.theclinics.com Gastroenterol Clin N Am 36 (2007) xiii–xiv GASTROENTEROLOGY CLINICS OF NORTH AMERICA gastroenterology which regards interactions of the. Parkman, MD Guest Editor T his issue of Gastroenterology Clinics of North America focuses on an important area in gastroenterology for both clinicians