Comparison of small‐bowel motility of the human jejunum and ileum

Abstract

Background Knowledge about human cyclic fasting motility (MMC) and the postprandial response is mostly based on manometric findings in the upper small intestine. Hardly any data exist on human ileal motility, as the acquisition of data has been limited by methodological concerns. The aim was to study human jejunal and ileal motility in an optimized manometric setting. Methods Solid‐state 24‐h‐manometry was performed in the jejunum and ileum of healthy individuals, applying a strict protocol for fasting, resting, and the consumption of a standardized meal. Both visual qualitative and validated computerized quantitative contraction and propagation analysis were performed. Key Results MMC occurs in similar frequency in the jejunum and ileum, but it was significantly shorter in the jejunum at night. By many characteristics, ileal motility was less intense and propagative than jejunal: less migrating clustered contractions, and slower propagation velocity and shorter distance in phases II and III, and postprandially – possibly slowing and enhancing nutrient absorption. Prolonged propagated contractions in some individuals were identified as a unique ileal propulsive pattern. Postprandially, an abrupt conversion to a digestive motility pattern occurs simultaneously independent of the region. Conclusions & Inferences We found similar basic phenomena of fasting and postprandial motility in the jejunum and ileum of healthy humans. However, different calibration of propagative and contractile activity and special motor events in the ileum may account for a different physiological role in digestion. Future studies of small‐bowel motility in healthy and diseased subjects focusing on segmental differences of proximal and distal intestine may be rewarded.

A fibrolytic potential in the human ileum mucosal microbiota revealed by functional metagenomic

“…Until now, the presence of monosaccharides (glucose, galactose or fructose) in the ileum was mainly explained by the digestive action of pancreatic α-amylase and some enterocyte brush-border membrane enzymes against complex carbohydrates37. These simple sugars are transported through the epithelial cells of the GI tract to finally reach the portal vein38.…”

Pathophysiology of Short Bowel Syndrome

“…78,85 In addition to these hormonal alterations, the amplitude, velocity, and propagation distance of postprandial contractions in the jejunum are significantly greater than in the ileum among healthy subjects. 86 Thus, the intrinsic transit time of nutrients through the jejunum may be faster than through the ileum, resulting in less contact time between the nutrient and the mucosa for digestion and absorption.…”

Gastrointestinal Motility, Part 2: Small-Bowel and Colon Transit

“…A second method uses a specially prepared, delayed-release, methacrylate resin-coated capsule containing 111 In-labeled activated charcoal particles. The coated capsule dissolves on reaching the alkaline terminal ileum, releasing the radioisotope into the lumen for subsequent measurement of colon transit (9). The third substitutes 67 Ga-complexes for 111 In-DTPA as part of a mixed solidliquid meal (10,11).…”

“…Antegrade and retrograde movements of intestinal chyme occur in the jejunum and ileum, with some areas progressing rapidly and others slowly. Jejunal peristaltic activity is typically more rapid and intense, with slowing of peristalsis seen in the ileum (9). This process, although irregular, results in a net overall progression of chyme toward the colon.…”