DISTORTIONS OF THE GASTRIC FEEDING REFLEX

The walls of the normal fasting stomach are maintained in coaptation by a state of tonus of its muscular coats, with recurrent periods of superimposed peristaltic activity. With the first taste of food there follows an immediate relaxation of gastric tonus with usually a fairly complete inhibition of peristalsis, resulting in a widening of the gastric lumen to accommodate the expected food injesta. This is the normal gastric feeding reflex (fig. 1). In the presence of various types of extragastric pathologic change, usually intra-abdominal or pelvic, this normal feeding reflex is distorted. Instead of relaxation there is an immediate increase in tone, with or without superimposed peristalsis. The degree of distortion roughly parallels the intensity of the sensory or psychic stimuli (fig. 2 A and B ) and is not influenced by the degree of acidity of the gastric secretions (table 1). These distortions of the normal gastric feeding reflex are