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  • The interactions between the neurophysiological processes and changes in muscle tone in the muscle groups that contribute to the sphincteric function of the gastro-esophageal segment: (a) the skeletal muscles of the crural sphincter, (b) the smooth muscles of the sling and clasp fiber complex, and (c) the transition in smooth muscle structure from the esophageal body into the sphincteric segment.
  • "Normal" interactions among these skeletal and smooth muscle groups to allow the sphincteric segment to function normally (i.e., to open to allow a bolus to be forced from the lower esophagus into the gastric cardia, closed to protect the lower esophagus against acid reflux, and open to allow belch and regurgitation when needed).
  • "Abnormal" interactions among these muscle groups that lead to mechanical failure and unwanted or chronic reflux.




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