Assessment of the afferent vagal nerve in patients with gastroesophageal reflux.
BACKGROUND
The objective of this study was to assess the integrity of the vagal nerve afferent pathways in patients with gastroesophageal reflux disease (GERD).


METHODS
Seven GERD patients (4 males and 3 females, mean age 39 +/- 8 years) were studied. Twelve healthy volunteers (11 males and 1 female, mean age 32 +/- 8 years) were used as the control group. Cortical evoked potentials were measured. Electrical stimulation of the esophageal mucosa was performed through a custom-built device. Latencies and N2/P2 amplitude were measured.


RESULTS
Reproducible cortical evoked potentials were obtained from all subjects. The stimulation threshold for GERD patients to electrical esophageal stimulation was 5.1 +/- 1.5 mA compared to 7.8 +/- 2.0 mA in healthy volunteers (p <0.05). There was no difference in peak latencies or N2/P2 amplitude between GERD patients and controls.


CONCLUSIONS
GERD patients have a normal vagal nerve function, but they exhibit a decreased threshold for esophageal perception. The mechanism responsible for increased esophageal sensitivity observed in GERD patients is still undetermined and warrants further study.
Hong
D
D
Department of Surgery, St. Joseph's Hospital, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada.
Kamath
M
M
Wang
S
S
Tabet
J
J
Tougas
G
G
Anvari
M
M
D000328:Adult; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000187:drug effects / Q000502:physiology; D004334:Drug Administration Schedule; D004558:Electric Stimulation / Q000295:instrumentation / Q000379:methods; D004947:Esophagus / Q000187:drug effects / Q000294:innervation / Q000503:physiopathology; D005071:Evoked Potentials / Q000187:drug effects / Q000502:physiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009092:Mucous Membrane / Q000187:drug effects / Q000294:innervation / Q000503:physiopathology; D009475:Neurons, Afferent / Q000187:drug effects / Q000502:physiology*; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use; D015203:Reproducibility of Results; D012684:Sensory Thresholds / Q000187:drug effects / Q000502:physiology; D014630:Vagus Nerve / Q000187:drug effects / Q000503:physiopathology*
D000897:Anti-Ulcer Agents; D009853:Omeprazole