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Nissen‐type fundoplication and its effects on the emetic reflex and gastric motility in the ferret
Author(s) -
Harriette Richards,
; Carr,
Spitz,
Milla,
Nathan Andrews
Publication year - 2000
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1046/j.1365-2982.2000.00181.x
Subject(s) - nissen fundoplication , motility , reflex , medicine , gastroparesis , anesthesia , gastroenterology , stomach , gastric emptying , biology , reflux , genetics , disease
Recurrent vomiting with failure to thrive is a common problem in neurologically impaired children. Many undergo fundoplication to control the underlying gastro‐oesophageal reflux. The results of surgery are not always satisfactory and post‐operative retching may be a major problem – a symptom indicative of activation of the emetic reflex. An animal model of antireflux surgery has been developed and used to investigate the effects of such surgery upon the emetic reflex and vagal influences on gastric motility. Following surgery, animals responded to a previously subemetic dose of a centrally acting opiate receptor agonist (loperamide), suggesting that fundoplication may sensitize the emetic reflex. A gastric vago‐vagal reflex (tonic inhibition of corpus tone) and responses to direct stimulation of vagal motor efferents (both cholinergic and nonadrenergic noncholinergic responses) were not significantly affected by antireflux surgery. Mechanisms by which neural damage may sensitize the emetic reflex are discussed, together with the possible clinical implications for the management of post‐operative symptoms in neurologically impaired children.