The site of denervation in achalasia.

Lower oesophageal sphincter supersensitivity to gastrin I and cholinergic stimulation has recently been described in patients with achalasia. To determine the pathogenesis of this finding, the lower oesophageal sphincter was tested to a cholinesterase inhibitor, edrophonium chloride. Edrophonium chloride significantly increased the lower oesophageal sphincter pressure both in normal subjects and in patients with achalasia. The preservation of this response in the presence of denervation supersensitivity suggested intact postganglionic cholinergic nerves and, thus, a preganglionic site of denervation in achalasia.