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. 1980 Mar 15;280(6216):755–757. doi: 10.1136/bmj.280.6216.755

Vagal function in relation to gastro-oesophageal reflux and associated motility changes.

R V Heatley, R J Collins, P D James, M Atkinson
PMCID: PMC1600605  PMID: 6989439

Abstract

Vagal function in 28 patients with gastro-oesophageal reflux was examined by determining gastric secretory response to insulin-induced hypoglycaemia and pulse-rate variation with respiration. Gastric secretory studies were also performed on 13 patients with duodenal ulcer who had not undergone operations. In all patients the presence and degree of oesophagitis were determined endoscopically and mucosal biopsy and oesophageal manometry were performed. Seven of the 28 patients with gastro-oesophageal reflux showed evidence of impaired vagal efferent function in the upper alimentary tract. No such impairment was found in those patients who showed manometric evidence of oesophageal spasm secondary to gastro-oesophageal reflux. Low pulse-rate variation with respiration was found in 12 of 27 patients with gastro-oesophageal reflux, suggesting dysfunction of cardiac vagal fibres. Impairment of efferent vagal supply may be a causative factor in some patients with gastr-oesophageal reflux but does not seem to be important in oesophageal spasm secondary to gastro-oesophageal reflux.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Angorn I. B., Dimopoulos G., Hegarty M. M., Moshal M. G. The effect of vagotomy on the lower oesophageal sphincter: a manometric study. Br J Surg. 1977 Jul;64(7):466–469. doi: 10.1002/bjs.1800640704. [DOI] [PubMed] [Google Scholar]
  2. CASELLA R. R., ELLIS F. H., Jr, BROWN A. L., Jr DIFFUSE SPASM OF THE LOWER PART OF THE ESOPHAGUS. FINE STRUCTURE OF ESOPHAGEAL SMOOTH MUSCLE AND NERVE. JAMA. 1965 Feb 1;191:379–382. doi: 10.1001/jama.1965.03080050025006. [DOI] [PubMed] [Google Scholar]
  3. Csendes A., Henriquez A. Gastric emptying in patients with reflux esophagitis or benign strictures of the esophagus secondary to reflux compared to controls. Scand J Gastroenterol. 1978;13(2):205–207. doi: 10.3109/00365527809181749. [DOI] [PubMed] [Google Scholar]
  4. Csendes A., Oster M., Brandsborg O., Möller J., Brandsborg M., Amdrup E. Gastroesophageal sphincter pressure and serum gastrin studies following food intake before and after vagotomy for duodenal ulcer. Scand J Gastroenterol. 1978;13(7):885–889. doi: 10.3109/00365527809182208. [DOI] [PubMed] [Google Scholar]
  5. Dodds W. J., Hogan W. J., Stef J. J., Miller W. N., Lydon S. B., Arndorfer R. C. A rapid pull-through technique for measuring lower esophageal sphincter pressure. Gastroenterology. 1975 Mar;68(3):437–443. [PubMed] [Google Scholar]
  6. Donovan I. A., Harding L. K., Keighley M. R., Griffin D. W., Collis J. L. Abnormalities of gastric emptying and pyloric reflux in uncomplicated hiatus hernia. Br J Surg. 1977 Dec;64(12):847–848. doi: 10.1002/bjs.1800641203. [DOI] [PubMed] [Google Scholar]
  7. Hosking D. J., Moody F., Stewart I. M., Atkinson M. Vagal impairment of gastric secretion in diabetic autonomic neuropathy. Br Med J. 1975 Jun 14;2(5971):588–590. doi: 10.1136/bmj.2.5971.588. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Lind J. F., Warrian W. G., Wankling W. J. Responses of the gastroesophageal junctional zone to increases in abdominal pressure. Can J Surg. 1966 Jan;9(1):32–38. [PubMed] [Google Scholar]
  9. Mann C. V., Hardcastle J. D. The effect of vagotomy on the human gastrooesophageal sphincter. Gut. 1968 Dec;9(6):688–695. doi: 10.1136/gut.9.6.688. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Stewart I. M., Hosking D. J., Preston B. J., Atkinson M. Oesophageal motor changes in diabetes mellitus. Thorax. 1976 Jun;31(3):278–283. doi: 10.1136/thx.31.3.278. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Venables C. W. The value of a combined pentagastrin-insulin test in studies of stomal ulceration. Br J Surg. 1970 Oct;57(10):757–761. doi: 10.1002/bjs.1800571015. [DOI] [PubMed] [Google Scholar]
  12. Williams J. A., Woodward D. A. The effect of subdiaphragmatic vagotomy on the function of the gastroesophageal sphincter. Surg Clin North Am. 1967 Dec;47(6):1341–1344. doi: 10.1016/s0039-6109(16)38383-9. [DOI] [PubMed] [Google Scholar]

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