Review: Neurology and medicine
Neurology and the gastrointestinal system
a Department of
Neuroscience and Psychological Medicine, The Hammersmith Trust
Hospitals, Charing Cross Hospital, London, UK, b Department of Gastroenterology, Chelsea and
Westminster Healthcare NHS Trust, Chelsea and Westminster Hospital,
London, UK
Correspondence to: Dr GD Perkin, Department of Neuroscience and Psychological Medicine, Imperial College School of Medicine, Charing Cross Hospital, Fulham Palace Road,London, W6 8RF, UK.
Received 11 February
1998 and in revised form 15 May 1998;
Accepted 15 May
1998
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
|---|
The
interrelation of neurology and the gastrointestinal system includes
defects of gut innervation, primary disorders of the nervous system (or
muscle) which lead to gastrointestinal symptoms
for example,
dysphagiaand, finally, certain gut disorders which include neurological features in their clinical range. The first of this trio
will be discussed only briefly in this review, the second and third in
more detail.
| |
Defects of innervation |
|---|
ACHALASIA
Achalasia is characterised by an absence of peristalsis in the
oesophageal body accompanied by a failure of relaxation of the lower
oesophageal sphincter.1 Although the condition can be
secondary to other disease processesfor example, Chagas' diseasein Europeans it is usually a primary disorder. Differing opinions have
been expressed as to whether the problem of innervation rests in the
dorsal motor vagal nucleus, the vagus itself, or in the intrinsic
innervation of the oesophagus, with most evidence favouring the last
explanation. By the time of oesophageal
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