GASTRIC MECHANOSENSORY AND LOWER ESOPHAGEAL SPHINCTER FUNCTION IN RUMINATION SYNDROME

Our hypothesis was that rumination syndrome is associated with gastric sensory and motor dysfunction. We studied gastric and somatic sensiti vity, reflex relaxation of the lower esophageal sphincter (LES), and g astric compliance and accommodation postprandially and postglucagon. A baro-statically controlled gastric bag and esophageal manometry were used to compare gastric sensorimotor functions and LES relaxation to g astric distension in 12 patients with rumination syndrome and 12 contr ols. During bag distensions, patients had greater nausea, bloating, an d aggregate score, but not pain, compared with controls (P < 0.05). At 4 and 8 mmHg gastric distension, LES tone reduction was greater in pa tients than in controls (P < 0.05). Gastric compliance, accommodation to a standard meal, and response to glucagon were not different in pat ients and controls; however 6 of 12 patients had no gastric accommodat ion; the latter patients had significantly greater pain perception dur ing distension (P < 0.05) but normal somatic sensitivity compared with healthy controls. Rumination syndrome is characterized by higher gast ric sensitivity and LES relaxation during gastric distension. A subgro up of patients also had absent postprandial accommodation.