The intrinsic innervation of the human alimentary tract and its relation to function.

Abstract

The intrinsic innervation of the human gut has been studied in strips of circular and longitudinal muscle removed at operation. Electrical stimulation of the nerves at a wide range of frequencies (0-1 to 128 Hz) can evoke a variety of responses due to activation of four types of nerves. There is evidence for cholinergic, adrenergic, non-adrenergic inhibitory, and non-cholinergic excitatory fibres, which may be stimulated at different frequencies. The various regions of the alimentary tract, and even the muscle layers within a region, may respond differently to nerve stimulation. This is most marked at 4 Hz and the observed differences correlate with the function of each part and its dependence on extrinsic innervation. The stomach is relatively insensitive to electrical stimulation, and this is consistent with its reliance on vagal innervation. The dominant excitatory responses in the longitudinal muscle of the oesophagus and ileum correlate with their high motility and propulsive function, whereas the dominant inhibitory responses in the colon correlate with its lower motility and storage function.