Abnormal Gastric Motor Function in Viral Gastroenteritis

Abstract

Nausea and vomiting occur commonly with gastroenteritis caused by parvovirus-like agents. Infection results in histologic injury to the small bowel mucosa, but the gastric mucosa remains unaffected. We have studied gastric emptying of liquids serially in 10 volunteers before and after ingestion of the parvovirus-like agents, Norwalk and Hawaii viruses. The five subjects who developed illness all showed marked delays in gastric emptying, while the five well subjects had no alteration of emptying. Five addition volunteers who developed Norwalk virus gastroenteritis underwent serial studies of gastric secretion of hydrochloric acid, pepsin, and intrinsic factor. No change was detected in either basal or betazole-stimulated secretion of these three substances during the course of illness. The nausea and vomiting accompanying this type of viral gastroenteritis may result from abnormal gastric motor function.

Murine Norovirus 1 Infection Is Associated with Histopathological Changes in Immunocompetent Hosts, but Clinical Disease Is Prevented by STAT1-Dependent Interferon Responses

“…5C). Interestingly, the delayed gastric emptying observed after human norovirus infection is considered the likely cause of the high incidence of vomiting episodes (28), but mice do not vomit because they lack an emetic reflex. It is therefore possible that mouse and human viruses in this genus cause similar intestinal pathologies but that there is no visible clinical outcome in the murine setting.…”

“…It is therefore possible that mouse and human viruses in this genus cause similar intestinal pathologies but that there is no visible clinical outcome in the murine setting. We are presently attempting to determine the basis of gastric bloating in MNV-1-infected STAT1 Ϫ/Ϫ mice, with possible explanations including decreased gastric motor function, as proposed for human norovirus infection (28), and pyloric inflammation. A more detailed understanding of how MNV-1 causes specific intestinal pathologies even in an immunodeficient setting may offer clues as to the prevention of human norovirus-induced disease.…”

Genogroup II Noroviruses Efficiently Bind to Heparan Sulfate Proteoglycan Associated with the Cellular Membrane

“…Only chimpanzees developed serologic responses when inoculated with NV/68, but they usually underwent an asymptomatic infection (82). Most of our understanding of NV infection has been obtained from epidemiological and volunteer studies (25,52,57,64).…”

Norovirus Gastroenteritis

“…43 Jejunal adenylate cyclase activity is not elevated, 42 and gastric secretion of hydrochloric acid, pepsin, and intrinsic factor has been associated with these histologic changes. In contrast, gastric emptying is delayed, 44 and the reduced gastric motility may be responsible for the nausea and vomiting associated with this gastroenteritis. The cause of the rapid and often explosive illness remains to be fully explained on a molecular basis.…”