Awareness is increasing that autoimmune attack targeted to neuronal elements of the
enteric nervous system may underlie irritable bowel-like symptoms that progress to chronic
pseudo-obstruction. The inflammatory neuropathy disrupts the integrative functions of the
brain-in-the-gut, including reduction in the population of inhibitory motor neurons to the
musculature. Extreme loss of inhibitory motor neurons is manifest as disinhibitory motor
disease characterized by achalasia in smooth muscle sphincters and hyperactive …