Modulation of gastric perception and motility in man. Current concepts and correlation with symptoms.

Gastric function is controlled by central and peripheral modulation. Most often, afferent information from the stomach does not reach conscious level. At extremes of chemical and mechanical stimulation, however, afferent signals are perceived as pain. Whether or not a signal is perceived depends on gating of afferent signals at the levels of both spinal cord and brainstem. Inhibition of gastric tone and peristalsis during perceived discomfort largely results from stimulation via sympathetic neural pathways. These findings may be clinically relevant because upper gastrointestinal symptoms in many dyspeptic patients could be the result of primary afferent neuron dysfunction rather than motor dysfunction.