Effects of nutrient liquids on human gastroduodenal motor activity.

Abstract

SUMMARY The effects of intragastric infusion of 10% Intralipid and 10% dextrose on the intraluminal pressures in the antrum, pylorus and duodenal bulb have been examined. Ten studies with each infusate have been performed in 10 normal subjects and the results compared with those obtained previously in 22 studies during intragastric infusion of isotonic saline. During saline infusion, contractile activity varied. In six studies fasting motor activity persisted; in the remainder, variable activity, without recognisable pattern was recorded. With saline, the gastroduodenal region usually functioned as a unit and the pylorus was the least autonomous part. Neither a sustained rise of basal pressure nor rhythmic, independent contractions were recorded from the pylorus. The contractile activity of the gastroduodenal region with Intralipid and dextrose was more uniform than with saline. Fasting motor activity was always abolished. The gastroduodenal region ceased to contract as a unit and the pylorus acquired autonomous activity. Rhythmic, independent contractions of the pylorus were recorded in nine of 10 studies during Intralipid infusion and six of 10 studies with dextrose. In addition, a sustained rise in pyloric basal pressure was recorded in eight of 10 studies with Intralipid and three of 10 studies with dextrose. Pyloric motility indices were significantly greater with fat than with dextrose. The observed differences in gastroduodenal motility are consistent with a role for the pylorus in the control of emptying of liquid from the stomach.Disagreement persists concerning the motility of the pylorus and gastroduodenal region. In dogs' and man2 3a raised basal pressure which was increased by intraduodenal infusion of fat or acid, has been recorded from the pylorus by some workers. Using the same techniques, however, others have failed to reproduce these results.-8 Berger,9 using a photoelectric device to register closure of the pylorus, showed that the normal human pylorus was usually open and contracted only when a contraction passed through the gastroduodenal region. Thus the pylorus does not appear to have an independent action and the whole gastroduodenal region acts as a unit.In a recent studyl we have used a different technique to obtain recordings of intraluminal pressure simultaneously from the antrum, pylorus, and duodenal bulb of normal subjects during intragastric infusion of isotonic saline. Under these Address for correspondence: Mr J Alexander-Williams FRCS, The General Hospital. Steelhouse Lane, Birmingham B4 6NH. Received for publication 25 February 1983 conditions the pylorus did not have an independent action. The studies with saline represent the effects of distension of the gastroduodenal region by an inert liquid. We have now used the same technique to examine the effects of distension with two nutrient liquids, 10% Intralipid and 10% dextrose. The effects of saline, fat and dextrose on gastroduodenal motility have been compared. Methods SUBJECTSAll subjects were healthy volunteers. In the ...

Ovine small bowel “minute rhythm” intensity related to feeding and phase of migrating myoelectric complex

“…It was also found in other own studies on sheep further confirming its frequent appearance (Romański, 2004;Romański, 2007b;Romański, 2009b;Romański, 2010). Furthermore, similar events, not identified explicitely as the MR, were found mostly in sheep (Bueno and Ruckebusch, 1979;Gregory et al, 1985;Grivel and Ruckebusch, 1972;Lester and Bolton, 1994;Poncet and Ivan, 1984;Ruckebusch, 1970;Ruckebusch, 1989), but also in man, dog and cattle (Andrews, 2001;Büh-ner and Ehrlein, 1989;Castedal et al, 1998, Defilippi, 2007Hasselbrack and Thomas, 1961;Ooms and Oyaert, 1978;Summers and Dusdieker, 1981;White et al, 1983). All the events could represent the MR pattern.…”

“…However, some authors found similar motor events using no specific terminology, i.e. not treating these events as the regular motility patterns (Bueno and Ruckebusch, 1979;Bühner and Ehrlein, 1989;White et al, 1983). Therefore, some doubts still exist regarding the evident identification of the MR resulting from the lack of its precise definition and characterisation.…”

Pyloric motor function during emptying of a liquid meal from the stomach in the conscious pig.

“…A pattern of non-propagated pressure waves localized to the pylorus has been demonstrated in humans (White, Poxon & Alexander-Williams, 1981; Heddle et al 1988a). These waves are stimulated by the intraduodenal infusion of various nutrient solutions (Fisher & Cohen, 1973; Poxon & Alexander- Williams, 1983;Heddle, Dent, Read, Houghton, Toouli, Horowitz, Maddern & Downton, 1988b;Heddle, Fone, Dent, Horowitz, 1988c Ehrlein and co-workers have similarly studied motor activity of the distal stomach, using extraluminal induction coils combined with radio-isotopic imaging of gastric emptying. Findings from Ehrlein's studies are largely in agreement with this study.…”

“…These changes are consistent with the motor pattern of isolated pyloric pressure waves we report. Induction coils, as used by Ehrlein and co-workers, signal the pyloric diameter and are not an effective method of recognizing a sequence of isolated pyloric pressure waves, as during the marked phasic pressure changes of IPPWs, the pyloric lumen rarely opens (GershonCohen, Shay & Fels, 1937;Tougas et al 1987;White et al 1983). The conclusion by Ehrlein that 'relaxation of the pyloric sphincter is more an isotonic than an isometric phenomenon' (Keinke et al 1984) is not necessarily correct.…”

Pyloric motility and liquid gastric emptying during barostatic control of gastric pressure in pigs.

“…The manometric assembly was positioned astride the gastroduodenal junction using dual-point transmucosal potential difference (TMPD) measurements (White, Poxon & Alexander-Williams, 1983). …”