Curbside Consultation of the Colon: 49 Clinical Questions

Brooks D. Cash, MD, FACP, CDR, MC, USN

Question 19: What Are The Emerging Therapeutic Agents For Constipation And How Do They Modulate Colonic Motility? (continued)

Brooks D. Cash, MD, FACP, FACG

The enteric nervous system (ENS) contains as many neurons as the spinal cord, which are spatially distributed along the digestive tract in close proximity to effector organs (smooth muscle, glandular epithelium), allowing for rapid, automatic feedback control. Interneurons and motor neurons are interconnected by chemical synapses to comprise functional neural networks that receive synaptic input from sensory neurons that detect changes in the thermal, chemical, or mechanical local environment.1 Understanding the functional basis of the ENS, especially with respect to motility and secretion…