[Interaction of motility and secretion of the stomach--pathophysiologic aspects].

The pathophysiologically most important disturbances in gastrooesophageal reflux disease are inappropriate relaxations and decreased basal pressure of the lower oesophageal sphincter. Slowed gastric emptying probably is an additional factor which may increase the likelihood of reflux. Changes in gastric secretion are of minor importance. In duodenal ulcer, the feedback inhibition of gastric emptying which is normally seen when acid is perfused in the duodenum is disturbed. Hence the duodenal bulb is exposed for a longer time to a low pH. Gastric vagatomy leads not only to decreased gastric secretion but also to quicker gastric emptying, in particular when a drainage procedure is performed concomitantly.