“…Studies that examined regions of the duodenum devoid of Brunner's glands have demonstrated that bicarbonate secretion is regulated by both extrinsic and intrinsic pathways. These include vago-vagal reflexes (2,7,15,16,23), reflexes within the submucosal plexus of the enteric nervous system (12), C fiber efferent mechanisms (11,29), and inputs from the sympathetic nervous system (5,6,22). The interactions between these neural pathways have also been studied, and the findings suggest that secretomotor reflexes within the submucosal plexus are modified by vagal and sympathetic efferents that provide excitatory and inhibitory inputs, respectively, to submucosal neurons (6,22).…”