Long-term metabolic effects of truncal vagotomy and gastrojejunostomy for chronic duodenal ulcer

Irving, Andy; Smith, Gordon I.; Coubrough, H

doi:10.1016/0261-5614(85)90017-2

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…In vagotomized subjects, dumping syndrome, malaise, anemia, and digestive issues commonly occur. However, the latter side effects were usually treatable and not directly correlated with weight loss in many patients (Faxen et al, 1979;Irving et al, 1985;Wills and Grusendorf, 1993). Instead, vagotomy has been reported to induce weight-loss with reduced food intake and modified food preference in obese subjects (Kral, 1978;Gortz et al, 1990).…”

Section: Satiation Without a Vagus Nerve Experimental And Clinical Vagotomiesmentioning

confidence: 99%

The Phantom Satiation Hypothesis of Bariatric Surgery

Gautron

2021

Front. Neurosci.

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The excitation of vagal mechanoreceptors located in the stomach wall directly contributes to satiation. Thus, a loss of gastric innervation would normally be expected to result in abrogated satiation, hyperphagia, and unwanted weight gain. While Roux-en-Y-gastric bypass (RYGB) inevitably results in gastric denervation, paradoxically, bypassed subjects continue to experience satiation. Inspired by the literature in neurology on phantom limbs, I propose a new hypothesis in which damage to the stomach innervation during RYGB, including its vagal supply, leads to large-scale maladaptive changes in viscerosensory nerves and connected brain circuits. As a result, satiation may continue to arise, sometimes at exaggerated levels, even in subjects with a denervated or truncated stomach. The same maladaptive changes may also contribute to dysautonomia, unexplained pain, and new emotional responses to eating. I further revisit the metabolic benefits of bariatric surgery, with an emphasis on RYGB, in the light of this phantom satiation hypothesis.

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Section: Satiation Without a Vagus Nerve Experimental And Clinical Vagotomiesmentioning

confidence: 99%

The Phantom Satiation Hypothesis of Bariatric Surgery

Gautron

2021

Front. Neurosci.

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“…The vagus nerve is also currently the focus of study as a target for weight loss. During the time‐period when vagotomy was carried out to treat peptic ulcers, postoperative weight loss and decreased appetite were frequently observed. However, these effects were not long‐term, and were attributed to the physical adaptation that occurs after vagotomy.…”

Section: Weight Loss Therapy Targeting the Vagus Nervementioning

confidence: 99%

Mechanistic relationship between the vagal afferent pathway, central nervous system and peripheral organs in appetite regulation

Ueno

Nakazato

2016

J of Diabetes Invest

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The hypothalamus is a center of food intake and energy metabolism regulation. Information signals from peripheral organs are mediated through the circulation or the vagal afferent pathway and input into the hypothalamus, where signals are integrated to determine various behaviors, such as eating. Numerous appetite‐regulating peptides are expressed in the central nervous system and the peripheral organs, and interact in a complex manner. Of such peptides, gut peptides are known to bind to receptors at the vagal afferent pathway terminal that extend into the mucosal layer of the digestive tract, modulate the electrical activity of the vagus nerve, and subsequently send signals to the solitary nucleus and furthermore to the hypothalamus. All peripheral peptides other than ghrelin suppress appetite, and they synergistically suppress appetite through the vagus nerve. In contrast, the appetite‐enhancing peptide, ghrelin, antagonizes the actions of appetite‐suppressing peptides through the vagus nerve, and appetite‐suppressing peptides have attenuated effects in obesity as a result of inflammation in the vagus nerve. With greater understanding of the mechanism for food intake and energy metabolism regulation, medications that apply the effects of appetite‐regulating peptides or implantable devices that electrically stimulate the vagus nerve are being investigated as novel treatments for obesity in basic and clinical studies.

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“…When vagotomy was used, years ago, as a therapeutic approach to cure peptic ulcers, it was associated with a decline of appetite and consequently with weight loss (Irving et al 1985). Therefore, the vagus nerve was regarded as a possible target for the treatment of obesity.…”

Section: Introductionmentioning

confidence: 99%

Roles of Gut Hormones in the Regulation of Food Intake and Body Weight

Castagneto-Gissey¹,

Mariolo²,

Mingrone³

2017

Endocrinology

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Within the health sciences, Endocrinology has an unique and pivotal role. This old, but continuously new science is the study of the various hormones and their actions and disorders in the body. The matter of Endocrinology are the glands, i.e. the organs that produce hormones, active on the metabolism, reproduction, food absorption and utilization, growth and development, behavior control, and several other complex functions of the organisms. Since hormones interact, affect, regulate and control virtually all body functions, Endocrinology not only is a very complex science, multidisciplinary in nature, but is one with the highest scientific turnover. Knowledge in the Endocrinological sciences is continuously changing and growing. In fact, the field of Endocrinology and Metabolism is one where the highest number of scientific publications continuously flourishes. The number of scientific journals dealing with hormones and the regulation of body chemistry is dramatically high. Furthermore, Endocrinology is directly related to genetics, neurology, immunology, rheumatology, gastroenterology, nephrology, orthopedics, cardiology, oncology, gland surgery, psychology, psychiatry, internal medicine, and basic sciences. All these fields are interested in updates in Endocrinology. The aim of the MRW in Endocrinology is to update the Endocrinological matter using the knowledge of the best experts in each section of Endocrinology: basic endocrinology, neuroendocrinology, endocrinological oncology, pancreas with diabetes and other metabolic disorders, thyroid, parathyroid and bone metabolism, adrenals and endocrine hypertension, sexuality, reproduction, and behavior.

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Long-term metabolic effects of truncal vagotomy and gastrojejunostomy for chronic duodenal ulcer

Cited by 5 publications

References 13 publications

The Phantom Satiation Hypothesis of Bariatric Surgery

The Phantom Satiation Hypothesis of Bariatric Surgery

Mechanistic relationship between the vagal afferent pathway, central nervous system and peripheral organs in appetite regulation

Roles of Gut Hormones in the Regulation of Food Intake and Body Weight

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