The effect of ileal infusion of lipid on the motility pattern in humans after ingestion of a viscous, non-nutrient meal By I. McL. WELCH and J. WORLDING (introduced by N. W. READ). Sub-Department of Human Gastrointestinal Physiology and Nutrition, The University, Sheffield 510 2T1 Previous studies have shown that an ileal infusion of lipid delays gastric emptying and slows small-bowel transit time in humans. The effects of ileal lipid on intestinal motility are however unclear. The aim of this study was to document the effect of ileal lipid on jejunal motor activity in eight healthy volunteers.Intrfluminal pressure changes were continuously recorded at seven sites, 4 cm apart, in the jejunum (the most proximal port located 100 cm from the teeth) following ingestion of a 300 ml, 40 guar gum meal, flavoured with diabetic orange squash. Isosmotic saline was infused into the distal ileum at a rate of 1 ml/min throughout the recording period (120 min), except for a 20 min infusion of 200% Intralipid, which commenced 30 min after ingestion of the test meal. Four of the eight subjects also completed a control study during which isosmotic saline was infused throughout the experiment.Ingestion of the guar gum meal induced a fed motility pattern in all 12 studies. Seven studies showed discrete clusters of contractions (3-15 in number) interspersed by periods of quiescence coordinated, and in many instances propagated through all seven pressure ports. One study showed irregular contractions through all the recording sites. Four studies showed a mixture of both irregular and clustered contractions.Ileal infusion of Intralipid in all eight subjects appeared to alter the postprandial motility pattern, leading to: a decrease in amplitude and frequency of contractions;or a reduction in the coordination of contraction clusters; or a reduction in the degree of propagation of coordinated contraction clusters; or a combination of these effects.No such alteration of motor activity was observed at similar times in the control experiments. A pattern resembling phase III of the migrating motor complex was observed within 120 min of ingestion of the meal in 3 out of 4 control studies but only in 2 out of 8 intralipid studies.In conclusion, infusion of lipid into the ileum alters motor activity in the jejunum in a manner that could account for a delay in small-bowel transit time.The protocol for this study was approved by the Ethical Sub-committee of the Sheffield Area Health Authority. The motor activity of the human pylorus and the role it plays in regulating gastric emptying is poorly defined. We have recorded pyloric pressures in 15 normal volunteers after they had ingested a meal of liver hamburger (100 g) with 200 ml of either normal saline (8 volunteers) or 25 % dextrose in normal saline (7 volunteers).Both solid and liquid phases were labelled with radioisotopes. Pyloric pressure was recorded using a sleeve sensor 4-5 cm long positioned by measuring the transmucosal p.d. at either end of the sleeve. Pressures were also measured a...