The physiology and the pathophysiology of the gastric accommodation reflex in man.

Summarizing the previous sections, we have demonstrated that the gastric accommodation reflex in man involves the release of serotonin and the activation of a nitrergic motor neuron. We observed that almost half of the patients with functional dyspepsia have an impaired accommodation reflex, and this is associated with early satiety and weight loss. Drug-induced inhibition of the accommodation reflex is able to induce early satiety in healthy subjects. Administration of the anti-migraine drug sumatriptan, an agonist at 5-HT1P receptors on gastric myenteric neurons, causes a relaxation of the proximal stomach in man through a nitrergic pathway. Pretreatment with sumatriptan is able to restore impaired accommodation and to improve early satiety in patients with functional dyspepsia. We conclude from these data that fundus-relaxing drugs may have a therapeutic potential in functional dyspepsia, and we hypothesize that fundus-contracting drugs may have therapeutic potential in the treatment of obesity.