Tissue engineering for neuromuscular disorders of the gastrointestinal tract

Table 1 Neuromuscular disorders of the gastrointestinal tract, current treatments and future regenerative medicine approaches

	Disorder	Neuromuscular diagnosis	Medical treatment	Surgical treatment
Esophagus
Body	↑ Contraction	Nutcracker	Nitrates	Myotomy
	↓ Contraction	Scleroderma	None	None
Lower esophageal sphincter	↑ Contraction	Achalasia	Botox	Myotomy
	↓ Relaxation	GERD	Nitrates	Fundoplication, RFA
	↓ Contraction		None
Stomach
Fundus	Failure of relaxation	Fundic dysfunction	None	None
	Excess relaxation	Fundic dysfunction	None	None
Body/antrum	↓ Contraction	Gastroparesis	Prokinetics	None
	↑ Contraction	Dumping syndrome	Anticholinergic drugs	Reverse small bowel segment
Pylorus	↑ Contraction	Pylorospasm	Botox	Pyloroplasty
	↓ Contraction	Dumping syndrome	Anticholinergic drugs	Reverse small bowel segment
Small intestine
Jejunum/ileum	↑ Contraction	Obstruction	None	Surgical resection
	↓ Contraction	CIPO	Prokinetics/antibiotics/STN	None
Ileocecal valve	↑ Contraction	Obstruction	None	Surgical resection
(sphincter)	↓ Contraction	Backwash ileitis	antibiotics	None
Colon
Ascending/transverse	↑ Contraction	IBS	Fiber, anticholinergic drugs	None
Sigmoid/rectum	↓ Contraction	Colonic inertia	Laxatives, lubiprostone	Colectomy
Anal sphincter	↑ Contraction	Anal outlet obstruction	Laxatives, botox	Myotomy
(internal)	↓ Contraction	Fecal incontinence	Fiber, injection	Sphincteroplasty
				Sacral nerve stimulation

↑: Increase; ↓: Decrease; CIPO: Chronic intestinal pseudo-obstruction; GERD: Gastroesophageal reflux disease; IBS: Irritable bowel syndrome; RFA: Radiofrequency ablation; STN: Somatostatin.