Relations among autonomic nerve dysfunction, oesophageal motility, and gastric emptying in gastro-oesophageal reflux disease.

Cunningham, Karen; Horowitz, Michael; Riddell, Peter; Maddern, Guy J.; Myers, Jennifer C.; Holloway, Richard H.; Wishart, Judith M.; Jamieson, Glyn G.

doi:10.1136/gut.32.12.1436

Cited by 136 publications

(103 citation statements)

References 31 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This problem may result from chronic entrapment of the stomach inside the hernia sac42, 43, 44. Restorative surgery might exacerbate this or simply expose symptoms that were minor or absent before surgery compared with other symptoms attributable to these large hernias.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for delayed gastric emptying following laparoscopic repair of very large hiatus hernias

et al. 2017

View full text Add to dashboard Cite

BackgroundDelayed gastric emptying can complicate surgery for hiatus hernia. The aim of this study was to quantify its incidence following laparoscopic repair of very large hiatus hernias, identify key risk factors for its occurrence and determine its impact on clinical outcomes.MethodsData collected from a randomized trial of patients who underwent laparoscopic mesh versus sutured repair of very large hiatus hernias (more than 50 per cent of stomach in chest) were analysed retrospectively. Delayed gastric emptying was defined as endoscopic evidence of solid food in the stomach after fasting for 6 h at 6 months after surgery.ResultsDelayed gastric emptying occurred in 19 of 102 patients (18·6 per cent). In univariable analysis, type 2 paraoesophageal hernia (relative risk (RR) 3·15, 95 per cent c.i. 1·41 to 7·06), concurrent anterior and posterior hiatal repair (RR 2·66, 1·14 to 6·18), hernia sac excision (RR 4·85, 1·65 to 14·24), 270°/360° fundoplication (RR 3·64, 1·72 to 7·68), division of short gastric vessels (RR 6·82, 2·12 to 21·90) and revisional surgery (RR 3·69, 1·73 to 7·87) correlated with delayed gastric emptying. In multivariable analysis, division of short gastric vessels (RR 6·27, 1·85 to 21·26) and revisional surgery (RR 6·19, 1·32 to 28·96) were independently associated with delayed gastric emptying. Delayed gastric emptying correlated with adverse gastrointestinal symptomatology, including higher rates of bloating, nausea, vomiting and anorexia, as well as reduced patient satisfaction with the operation and recovery.ConclusionDelayed gastric emptying following large hiatus hernia repair is common and associated with adverse symptoms and reduced patient satisfaction. Division of short gastric vessels and revisional surgery were independently associated with its occurrence.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors for delayed gastric emptying following laparoscopic repair of very large hiatus hernias

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Also, the same authors claimed that asthmatic patients demonstrated a vagal hyper-reactivity rather than a vagal hypofunction. On the other hand, some investigators reported that in GERD patients, there is no correlation between autonomic function and esophageal motility or esophageal acid exposure [25] . In conclusion, patients with GERD have distortion of both components of autonomic nervous system, sympathetic and parasympathetic.The impairment of parasympathetic function seems to be more congruent to GERD and it may be the result of vagal fiber damage.The mechanism of impairment of parasympathetic function of the patients with GERD is not completely clear, but in all autonomic neuropathies, the first stage of dysfunction is damage of parasympathetic neurons, possibly because the general function of the autonomic nervous system depends on vagal activity.…”

Section: Discussionmentioning

confidence: 99%

Cardiac autonomic dysfunction in patients with gastroesophageal reflux disease

Milovanovic

Filipović

Mutavdzin

et al. 2015

WJG

View full text Add to dashboard Cite

“…In GERD, there is a high prevalence of vagus nerve dysfunction, which relates to delayed esophageal transit, abnormal peristalsis, and increased frequency of transient lower esophageal sphincter relaxations. 15,16 Because the immune system is under the direct control of the vagus nerve via the cholinergic anti-inflammatory pathways, vagus nerve dysfunction may set off excessive inflammatory responses and the spread of inflammatory mediators into the blood- …”

Section: Discussionmentioning

confidence: 99%

Reflux Esophagitis and the Risk of Stroke in Young Adults

Sheu

Kang

Lou

et al. 2010

Stroke

View full text Add to dashboard Cite

Background and Purpose-Reflux esophagitis (RE) is the most common manifestation of gastro-esophageal reflux disease with esophageal injury. To the best of our knowledge, there has been no specific study to evaluate the risk of stroke after diagnosis of RE in young adults. This study aims to evaluate the risk of stroke among RE patients aged 18 to 50 years during a 1-year period after diagnosis of RE compared to a cohort of non-RE patients during the same period. Methods-This study used the Taiwan Longitudinal Health Insurance Database 2005. A total of 2340 RE patients were included as the study cohort and 11 700 non-RE patients were included as the comparison cohort. Each patient was individually tracked for 1 year from the index ambulatory visit to identify those in whom stroke developed. Results-Out of the sample of 14 040 patients, 78 patients (0.56%) had strokes develop during the 1-year follow-up period:22 from the study cohort (0.94% of the RE patients) and 56 from the comparison cohort (0.48% of patients without RE).Patients with RE were 1.68-times more likely to have strokes develop (95% confidence interval, 1.03-2.76) than patients in the comparison cohort during the follow-up period after adjusting for patients' medical comorbidities, such as hypertension, diabetes, coronary heart disease, renal disease, heart failure, and hyperlipidemia, as well as their demographic differences, such as the level of urbanization of their communities, monthly income, and geographical location. Conclusions-We conclude that RE is associated with an increased risk of subsequent stroke in young adults. (Stroke.

show abstract

Relations among autonomic nerve dysfunction, oesophageal motility, and gastric emptying in gastro-oesophageal reflux disease.

Cited by 136 publications

References 31 publications

Risk factors for delayed gastric emptying following laparoscopic repair of very large hiatus hernias

Risk factors for delayed gastric emptying following laparoscopic repair of very large hiatus hernias

Cardiac autonomic dysfunction in patients with gastroesophageal reflux disease

Reflux Esophagitis and the Risk of Stroke in Young Adults

Contact Info

Product

Resources

About