**2. Functional disorders of the gastrointestinal tract**

The digestive tube is one of the systems most affected in terms of functional disorders. Rich gastrointestinal tract innervation of mainly vegetative nerve fibers is closely connected with and thereby influences function and activity of the central nervous system.

Gastrointestinal tract disturbances can be divided into esophageal (chest pain, functional heartburn, functional dysphagia), gastroduodenal (functional dyspepsia, etc.), intestinal disorders (irritable bowel syndrome, functional constipation or diarrhea), functional abdominal pain, biliary disorders, and anorectal disorders. In terms of pathogenesis, functional gastrointestinal motility disorders, visceral hypersensitivity, and intolerance to certain food components have been cited as principal contributing factors. Although musculoskeletal changes occur in approximately 60% of patients with functional bowel disorders, relatively little research has examined vertebrovisceral functional relationships.

Swallowing Disorders Related to Vertebrogenic Dysfunctions 177

In the next phase, which is a continuation of the swallowing reflex and is not considered a separate phase, the lower pharyngeal sphincter activity shifts the bite to the beginning of the esophagus, followed by transport due to esophageal muscle activity. Elevated pharynx and larynx return caudally. At the same time, swallowing ventilates the middle-ear cavity. Transport of food from the mouth into the upper esophagus is related to the coordinated relaxation of the upper esophageal sphincter, which is a consequence of inhibitory signals from the masticatory center through n. vagus. Sphincter tone can be influenced by local

In the third phase, food is propelled by the coordinated peristaltic wave of esophagus muscles that move aborally at the rate of 3 cm/s when the lower esophageal sphincter is relaxed. Peristaltic wave speed is affected by many factors, especially by the temperature and volume of the swallowed food. If the interval between swallowing two mouthfuls is less

The lower esophageal sphincter is a smooth muscle area with a length of 3 cm that separates the esophagus from the stomach. It prevents reflux of gastric contents back into the esophagus during swallowing and performs coordinated relaxation allowing the passage of food from the esophagus to the stomach. Its activity can be influenced by myogenic, neural, and humoral factors. The pressure increase is caused by gastrin, motilin, prostaglandin, and histamine. By contrast, a reduction occurs under the influence of cholecystokinine, secretine, glucagone, progesterone, neurotensin. The physiological significance of some of these

The function of the esophagus is affected by autonomic innervation activity. The enteric system is relatively independent and regulates many functions of the digestive tube. Enteric system (myenteric and submucous) is under the influence of signals from CNS and receptors in the tube wall (mechanoreceptors, chemoreceptors, and thermoreceptors)

The autonomic nervous system does not work separately from cortical and subcortical structures. The peripheral autonomic nervous system function is subject - to a large extent to the regulations of the central nervous system (except the voluntary control), which provides a comprehensive and targeted response. Another function of the digestive tube modulation is the relationship between the enteric nervous system, central nervous system, and the immune system in the gastrointestinal tract. This can explain the influence of stress

Dysphagia is a symptom of numerous organic and functional disorders. Impaired swallowing can be high (oropharyngeal) or low (esophageal). Organic dysphagia is characterized by permanent dysphagia (stricture, tumor). Functional dysphagia is that one caused by motility disorders (usually spasms) and has the character of intermittent problems. With these distinct characteristics, patient's history is important in terms of a

Obstructive swallowing disorders: Esophageal tumor, extramural compression, congenital

major or single base diagnosis. The causes of dysphagia are varied and numerous.

abnormalities (stenosis, atresia), inflammation, trauma (burns, scars, foreign bodies).

than 10 seconds, swallowing is often not followed by a peristaltic wave.

(Bharucha & Camilleri, 2003, Bielefeldt & Gebhart, 2004).

on the occurence or worsening of symptoms in the digestive tract.

**4. Differential diagnosis of swallowing disorders** 

factors such as pH in the esophagus.

substances is questionable.
