The Longitudinal Muscle in Esophageal Disease

By O. Arthur Stiennon, M.D.

About the Author

This is likely to be the only reference to the longitudinal muscle (LM) you will find on the net. Although it constitutes more than 50% of the esophageal muscle mass and accounts for about 90% of esophageal problems, the LM has been ignored in the literature. Nevertheless, here are 300 pages that tell you all about it with startling new insights.

This page and its links contain all of the text and supporting references as well as the 250 illustrations that make up the proof. The book is also available as a hard copy which can be ordered from






A Boolean model of the esophagus

The mechanism of mucosal fold formation

The captive bolus

Where is the sphincter?

Reflex control of the sphincter

Gas/bloat and the physiology of belching

The function of a hiccup

Longitudinal muscle contraction

The lower esophageal ring

The LM and GE reflux

Complications of LM tension

"Hiatus hernia" and rupture of the PE ligament

"Achalasia" and related misdiagnoses

Mallory-Weiss syndrome

The (dubious) Barrett esophagus

Summing up

Appendix A

Appendix B

Copyright 1995, 1996 by O. Arthur Stiennon

Library of Congress Catalogue Card Number 94-61983

ISBN 0-9644594-0-X

Internet edition

This edition may be reproduced for non-commercial purposes without

written permission of the copyright owner.

This text contains the research, the logic, the conclusions, and the illustrations that are also included in the printed book. The 250 radiographs are essential for the radiologist, who can save patients the enormous expense and discomfort of endoscopic and manometric procedures. One can study the sphincter for years, but one picture will dispel the nonsense that has been written about it -- its length, its location, its ablation. Be one of the very few who have actually seen a belch or exquisite 12-17 exposure sequences of longitudinal muscle contraction's effect on the sphincter, diaphragm and PEL. The diagrams are essential to understanding the true nature and cause of "hiatus hernias", the interrelationships among organ size, mucosal thickness and fold number and the migration of muscular states in 3-D. It's thorough study will be the foundation of your research proposal.

Ask your medical librarian to order this book for you or order it yourself.

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For information on ordering outside the continental U.S. or for ordering in quantity, please contact WRS Press, Suite 303, 700 Regent Street, Madison,WI 53715, Phone 800/628-7927, FAX 608/255-1760.

Last Updated on July 20, 2007 by David PJ Stiennon