The purpose of this review is to examine the role of vagal influence on the regulation of gastric acid secretion in humans, and to answer the question as to whether there is any indication of increased vagal tonus being involved in the pathogenesis of peptic ulcers. Apart from the central importance of vagal influence on gastric acid secretion, there is no direct evidence for the existence of general vagal hyperactivity in peptic ulcer patients. Increased vagal activity can only be indirectly demonstrated for a subgroup of duodenal ulcer patients. The involvement of psychodynamic factors as a background phenomenon is emphasized.
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