Enteric Neuromuscular Pathology Update

Clinically, study of the neuromuscular pathology of digestive motility disorders equates with study and histologic examination of biopsied or resected full-thickness human gastrointestinal tissues. This article covers several general principles and problems of diagnosis in this field from the perspective of methodological and interpretative variability. It then addresses the main current indications for histologic examination of tissues from patients with suspected enteric neuromuscular disease on the basis of clinically defined primary and secondary digestive motility disorders. It considers findings in achalasia, gastroparesis, intestinal pseudo-obstruction, enteric dysmotility, slow-transit constipation, and megacolon, thereby highlighting recent important findings and ongoing challenges.