Hormonal Control of Esophageal Function

During the past decade, no concept in esophageal physiology or pathophysiology has generated more interest than the proposal that esophageal function may be regulated by the gastrointestinal hormones. Prior to the finding that hormonal substances released in the gastrointestinal tract altered esophageal muscular function, one generally conceived of the esophagus and its sphincters as static systems that responded only to mechanical forces and neural stimuli. The control of esophageal function by peptide hormones released during the normal digestive processes suggested that many unexplained esophageal symptoms may now be clarified by demonstrating pathophysiologic mechanisms of hormonal action. Furthermore, the treatment of these disorders seemed possible through changing these hormonal effects. The purpose of this review is twofold: first, to describe in detail the effect of each gastrointestinal hormone on esophageal function in man; and second, to evaluate the possible role of this hormonal action in specific esophageal disorders. Most of this