Esophageal ganglia and smooth muscle in the elderly.

Esophageal motor dysfunction is a common finding in elderly persons, but its etiology remains unknown. We examined the histology of Auerbach's plexus and esophageal smooth muscle in autopsy material from young and old subjects. There was a significant decrease in ganglion cells per square centimeter (1685 +/- 115.9) in old subjects when compared to young controls (2253 +/- 216.9) (P less than 0.05). Lymphocytic infiltration of Auerbach's plexus was commonly observed in both groups of patients, but heavy lymphocytic infiltration was slightly more common in elderly subjects. No difference was found in thickness of esophageal smooth muscle between young and old subjects. It is concluded that diminution of ganglion cells rather than smooth muscle atrophy may explain the frequent occurrence of esophageal motor dysfunction in elderly persons.