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Published in:

01-02-2014 | Review

Gastric sensitivity and reflexes: basic mechanisms underlying clinical problems

Authors: Fernando Azpiroz, Christine Feinle-Bisset, David Grundy, Jan Tack

Published in: Journal of Gastroenterology | Issue 2/2014

Abstract

Both reflex and sensory mechanisms control the function of the stomach, and disturbances in these mechanisms may explain the pathophysiology of disorders of gastric function. The objective of this report is to perform a literature-based critical analysis of new, relevant or conflicting information on gastric sensitivity and reflexes, with particular emphasis on the comprehensive integration of basic and clinical research data. The stomach exerts both phasic and tonic muscular (contractile and relaxatory) activity. Gastric tone determines the capacity of the stomach and mediates both gastric accommodation to a meal as well as gastric emptying, by partial relaxation or progressive recontraction, respectively. Perception and reflex afferent pathways from the stomach are activated independently by specific stimuli, suggesting that the terminal nerve endings operate as specialized receptors. Particularly, perception appears to be related to stimulation of tension receptors, while the existence of volume receptors in the stomach is uncertain. Reliable techniques have been developed to measure gastric perception and reflexes both in experimental and clinical conditions, and have facilitated the identification of abnormal responses in patients with gastric disorders. Gastroparesis is characterised by impaired gastric tone and contractility, whereas patients with functional dyspepsia have impaired accommodation, associated with antral distention and increased gastric sensitivity. An integrated view of fragmented knowledge allows the design of pathophysiological models in an attempt to explain disorders of gastric function, and may facilitate the development of mechanistically orientated treatments.

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Title: Gastric sensitivity and reflexes: basic mechanisms underlying clinical problems
Authors: Fernando Azpiroz
Christine Feinle-Bisset
David Grundy
Jan Tack
Publication date: 01-02-2014
Publisher: Springer Japan
Published in: Journal of Gastroenterology / Issue 2/2014
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI: https://doi.org/10.1007/s00535-013-0917-8

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