Esophageal motility

Animal studies continue to provide evidence that nitric oxide is an important mediator of lower esophageal tone with additional effects on the body. Several motility changes occur with age, including aperistalsis of unknown origin, contributing to swallowing difficulties. Motilin agonists, like erythromycin, increase lower esophageal sphincter pressure, suggesting possible benefit in reflux disease. Evaluation of esophageal causes of noncardiac chest pain seems to be of clinical benefit. Pneumatic dilatation or surgery are equally effective approaches to achalasia. Botulinum toxin injection holds promise in treating this disorder. The primary abnormality in reflux disease seems to be abnormal motility. Scleroderma-like motility abnormalities have been described in breast-fed children of mothers with silicon breast implants.