Evidence map›Paper›PMID 42133357›Full record

ReviewPhysiological reviews2026

Esophageal peristalsis in health and disease: mechanistic insights.

Ravinder K Mittal, Yifeng Bu, Nick J Spencer

Abstract readReview
In one paragraph

Review in Physiological reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Ravinder K MittalDivision of Gastroenterology, Department of Medicine, University of California San Diego, San Diego, California, United States.ORCID 0000-0001-5228-9617
Yifeng BuQualcomm Institute, University of California San Diego, La Jolla, California, United States.ORCID 0000-0002-9336-4748
Nick J SpencerCollege of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.ORCID 0000-0003-2190-5303

Funding

Novel Electrical Impedance Methodology to Understand Functional DysphagiaR01DK109376 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MITTAL, RAVINDER K. · 2016 to 2020
$2.5M
Mechanistic and clinical outcomes of a surgical innovation aimed at minimizing GERD associated with vertical sleeve gastrectomy (INNOVATE-VSG)R01DK138047 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI RAVINDER K. MITTAL, NINH T NGUYEN · 2024 to 2026
$944k
Novel Electrical Impedance Methodology to Understand Functional DysphagiaR56DK109376 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MITTAL, RAVINDER K., ZIFAN, ALI · 2023 to 2023
$682k
Hiatal Dysfunction in Achalasia EsophagusR56DK129451 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MITTAL, RAVINDER K. · 2021 to 2021
$663k
Department of Education and Training | Australian Research Council (ARC) 1156427Department of Education and Training | Australian Research Council (ARC) Discovery Grant #DP220100070NIDDK NIH HHS R01 DK109376NIDDK NIH HHS R01 DK138047NIDDK NIH HHS R56 DK109376NIDDK NIH HHS R56 DK129451VA MERIT
6 · The paper itself

Abstract

The mechanism of esophageal peristalsis or sequential contractions of the skeletal and smooth muscle esophagus resides at multiple levels, i.e., brain stem (central pattern generator), neurons within the wall of the esophagus (myenteric plexus), and smooth muscle (myogenic). Esophageal peristalsis consists of initial inhibition followed by excitation, for which there may be parallel pathways from the central pattern generator, traveling via the vagus nerve to communicate with the inhibitory and excitatory neurons of the myenteric plexus. Primary and secondary esophageal peristalsis are associated with concurrent contraction and relaxation of the circular and longitudinal muscle layers. The longitudinal muscle contraction in the contracted segment exerts mechanical stretch on the segment ahead of it, which likely activates the mechanosensitive inhibitory motor neurons in the myenteric plexus to induce descending relaxation, a peripheral mechanism of the peristaltic reflex. In achalasia esophagus, there is inflammation and fibrosis in the muscularis propria and myenteric plexus, resulting in loss of inhibitory nerves in the myenteric plexus. It also results in replacement of muscle with fibrous tissue in the muscularis propria of the lower esophageal sphincter (LES), impaired LES relaxation, and low distensibility of the esophagogastric junction in achalasia esophagus. The esophageal hiatus contains a pad of fat that is replaced with fibrosis in patients with achalasia esophagus. Whether hiatal fibrosis leads to impaired LES relaxation/low distensibility of the esophagogastric junction and changes in esophageal peristalsis are secondary to obstruction requires further study. Esophageal hypersensitivity is currently the favored mechanism of "angina-like" esophageal pain and refractory heartburn. Spastic or long-duration contractions of the longitudinal muscle of the esophagus may also play a role in the genesis of noncardiac esophageal pain and heartburn sensation.

Indexed as

Esophageal Motility DisordersEsophagusPeristalsisAnimalsHumansMuscle ContractionMuscle, Smoothachalasia esophagusesophageal peristalsislongitudinal muscle esophagusmechanosensitive neuronsmyenteric plexus

Identifiers

PMID42133357
PMCPMC13355913

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.