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Assessment of Vagus Nerve Injury Through Sham Feeding
Tian Li1, Sabrina Billings2, Rex-Kam Siu2
1Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
Digestive Diseases and Sciences
|June 10, 2026
Summary
Sham feeding effectively assesses vagal nerve function, especially for nausea and vomiting. This test shows abnormal results in patients with these symptoms, unlike gastric emptying scans.
Area of Science:
- Gastroenterology
- Neurogastroenterology
- Surgical Innovation
Background:
- Vagal nerve injury presents nonspecific symptoms, complicating diagnosis.
- Pancreatic polypeptide (PP) release post-sham feeding serves as a key indicator of vagal nerve function.
- Assessing vagal integrity is crucial for managing gastrointestinal disorders.
Purpose of the Study:
- To evaluate vagal nerve integrity using sham feeding-induced pancreatic polypeptide (PP) measurement.
- To examine the relationship between patient symptoms, PP levels, and gastric emptying.
- To determine the diagnostic value of sham feeding for gastrointestinal symptoms.
Main Methods:
- Retrospective analysis of patients undergoing sham feeding between 2018 and May 2025.
- Collected demographic, clinical, sham feeding, and gastric emptying data.
- Defined normal vagal function as a 50% PP increase within 30 minutes; delayed gastric emptying as >25% retention at 4 hours.
Main Results:
- 53 patients (58.5% female, mean age 57.2 years) were included.
- Nausea/vomiting (40%) and diarrhea (26.4%) were the most common GI symptoms.
- Abnormal sham feeding results strongly correlated with nausea/vomiting (91.3%), unlike gastric emptying (60.9%).
Conclusions:
- Sham feeding demonstrates consistent abnormalities in patients with predominant nausea and vomiting.
- Gastric scintigraphy results showed a non-significant correlation with gastroparesis symptoms.
- Sham feeding emerges as a valuable diagnostic tool for evaluating patients presenting with nausea and vomiting.
