Gastric and lower esophageal sphincter pressures during nausea: a study using visual motion-induced nausea and high-resolution manometry

Schaub, Nora; Ng, Kee Seong; Kuo, Paul; Aziz, Qasim; Sifrim, Daniel

doi:10.1152/ajpgi.00412.2013

Cited by 13 publications

(5 citation statements)

References 38 publications

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“…Both the enteric and central nervous systems participate in eliciting these changes in gut motility (Lang, 2015). In some (but not all) humans, decreases in gastric fundus and lower esophageal pressure have been shown to occur during nauseogenic stimuli (Schaub et al, 2014), supporting Lang’s findings about gastric relaxation prior to emesis.…”

Section: Prodromal Physiological Changes: Potential Physiological mentioning

confidence: 52%

What is nausea? A historical analysis of changing views

Balaban

Yates

2017

Autonomic Neuroscience

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The connotation of “nausea” has changed across several millennia. The medical term ‘nausea’ is derived from the classical Greek terms ναυτια and ναυσια, which designated the signs and symptoms of seasickness. In classical texts, nausea referred to a wide range of perceptions and actions, including lethargy and disengagement, headache (migraine), and anorexia, with an awareness that vomiting was imminent only when the condition was severe. However, some recent articles have limited the definition to the sensations that immediately precede emesis. Defining nausea is complicated by the fact that it has many triggers, and can build-up slowly or rapidly, such that the prodromal signs and symptoms can vary. In particular, disengagement responses referred to as the “sopite syndrome” are typically present only when emetic stimuli are moderately provocative, and do not quickly culminate in vomiting or disengagement from the triggering event. This review considers how the definition of “nausea” has evolved over time, and summarizes the physiological changes that occur prior to vomiting that may be indicative of nausea. Also described are differences in the perception of nausea, as well as the accompanying physiological responses, that occur with varying stimuli. This information is synthesized to provide an operational definition of nausea.

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Section: Prodromal Physiological Changes: Potential Physiological mentioning

confidence: 52%

What is nausea? A historical analysis of changing views

Balaban

Yates

2017

Autonomic Neuroscience

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“…The vagal and sympathetic innervation of the esophagus and the heart are closely related, with numerous visceral afferent fibers originating in the distal esophagus that can influence cardiac autonomic behavior 20 . It is known that many gut reflexes, such as acid perfusion tests 17 and gastric receptive relaxation 21 occur through reflex arcs involving sensory afferent as well as efferent vagal pathways. Of interest, nasogastric intubation (or anticipation of NGI) causes a presumed common pathway to heart and esophagus, resulting in either vagal withdrawal or sympathetic activation.…”

Section: Discussionmentioning

confidence: 99%

An investigation into the effect of nasogastric intubation on markers of autonomic nervous function

Abdul-Razakq

Emmanuel

Brugaletta

et al. 2021

Neurogastroenterology Motil

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Background: Nasogastric (NG) intubation for esophageal manometry can be traumatic and may be associated with a temporary reduction/absence in esophageal peristalsis.This study explored the prevalence and effect on esophageal motor function. We also hypothesized that baseline anxiety as well as markers of autonomic nerve function were correlated to attenuated esophageal peristalsis. Methods: Twenty-seven patients with esophageal symptoms referred for esophageal manometry investigation (mean age 56.8 ± 16.7 years, range 23-85 years) reported baseline anxiety score (Likert scale) preintubation. Patients had continuous heart rate and blood pressure measured prior to intubation and until 10 min after catheter withdrawal. Quality of motility was assessed for each 5 ml water swallow using standard Chicago Classification metrics. Key Results: Nasogastric-intubation elicited a significant increase in heart rate (p < 0.001), systolic (p < 0.001) and diastolic (p < 0.001) blood pressure, which was in part anticipatory. The median time taken for patients' first hypotensive peristalsis (Distal Contractile Integral; DCI ≥100 mmHg s cm) was 130 s (Interquartile range; 47-242 s) and for their first normal peristalsis (DCI ≥450 mm Hg s cm) was 150 s (IQR 61-320 s), with improvement and consistent stabilization in DCI there onward. This corresponded closely to the time for initial recovery of heart rate and systolic and diastolic blood pressure postintubation. Conclusions and Inferences: Nasogastric intubation resulted in heightened sympathetic responses and/or dampened parasympathetic responses, and an associated temporary reduction or absence in esophageal peristalsis.

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“…Vomiting is another case in which the GEJHPZ relaxes. Nausea prior to vomiting decreases pressure in the GEJHPZ in human subjects, even when induced by visual stimuli (Schaub, Ng, Kuo, Aziz, & Sifrim, 2014). The process of vomiting has been described as occurring in three stages, with the first two resulting in retrograde flow from the intestine into the stomach and an increase in abdominal pressure (Horn, 2017).…”

Section: Neuromuscular Physiologymentioning

confidence: 99%