How Does Morphine Work on Colonic Motility? An Electromyographic Study in the Human Left and Sigmoid Colon

Schang, J. C.; Mond, M. H; Bert, Marc; Pilote, M.

doi:10.1097/00132586-198610000-00003

Cited by 10 publications

(11 citation statements)

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“…In vivo experiments regarding the effects of serotonin have shown very inconsistent results, probably because of the multiplicity of the serotonin receptor subtypes. Serotonin is known to exert a both direct and indirect (mediated by cholinergic nerves) excitatory effect on smooth muscle [47–52]. At present there are at least five subtypes of serotonin receptors found in the GI tract [53].…”

Section: Discussionmentioning

confidence: 99%

Variability in serotonin and enterochromaffin cells in patients with colonic inertia and idiopathic diarrhoea as compared to normal controls

et al. 2002

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AIM: To evaluate differences in distribution, density and staining intensity of enterochromaffin cells (EC) and serotonin cells (SC) in the colonic mucosa of patients with colonic inertia (CI), idiopathic diarrhoea (ID) and a control group. METHODS: Three groups were studied: 19 patients' colons after subtotal colectomy for CI, and 17 patients' biopsies for diarrhoea (>3 bowel movements/day) with histological findings of normal mucosa (excluding microscopic, eosinophillic and collagenous colitis). The third group included 15 patients who underwent colonoscopy and biopsy for indications other than constipation, inflammatory bowel disease, diarrhoea or neoplasm (control group). Specimen blocks were obtained in each case from the right and left colon. Immunohistochemical staining for EC and SC were done on 4 micro m sections from Hollandes fixed, paraffin embedded tissues with primary rabbit antibody against chromagranin A or serotonin, and biotynylated secondary antibody and enzyme labelled streptavidin. RESULTS: The number of EC in the mucosa of the left colon in patients with CI (16.8 +/- 10.2) and ID (19.9 +/- 9.7) were significantly higher than they were on the right side (CI: 9.4 +/- 6.0, ID: 12.1 +/- 5.3). However, there were no significant differences between the left and right sides in the control group (L: 10.3 +/- 5.3; R: 13.4 +/- 7.6). Although the quantity of EC in the left colon in both patients with CI (P < 0.05) and ID (P < 0.01) were significantly higher than in the controls, there was no significant difference between CI and ID. In both the right and left colon, the percentage of EC with low positive density was significantly higher (P < 0.01) while those cells with moderate or low staining intensity were significantly lower in patients with CI than in either patients with ID or control group. In patients with CI, the quantity of SC in the mucosa of the left colon (12.1 +/- 6.4) was higher than in the right (CI: 7.9 +/- 3.6; control 4.6 +/- 3.3; ID 4.6 +/- 2.9) (P = 0.0057). In contrast there was no significant difference in SC in either the ID or control groups. The quantity of SC in both sides of the colon was significantly higher both in patients with CI as compared to the control group (P < 0.01) and patients with CI vs. patients with ID (L = P < 0.01; R = P < 0.05). There was a significantly positive correlation between the numbers of EC and SC in patients with CI (L: r = 0.5425, P < 0.05; R: r = 0.745, P < 0.01). CONCLUSION: In patients with CI, EC increases possibly due to an increase in SC. Conversely, in patients with ID, the EC increase results from peptides other than SC. Our results suggest that different aetiological factors contribute to ID and CI.

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Section: Discussionmentioning

confidence: 99%

Variability in serotonin and enterochromaffin cells in patients with colonic inertia and idiopathic diarrhoea as compared to normal controls

et al. 2002

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“…Such agents include opioid analgesics, non‐steroidal anti‐inflammatory drugs (NSAIDs) and corticosteroids. Opioid analgesics increase intracolonic pressure and slow colonic transit7, 8, and NSAIDs have local and systemic actions that may reduce the integrity of the colonic wall9, 10. Corticosteroids are powerful immunosuppressive drugs that may impair the normal protective responses to inflammation and infection11, 12.…”

Section: Introductionmentioning

confidence: 99%

Anti-inflammatory drugs, analgesics and the risk of perforated colonic diverticular disease

Morris

Harvey

Stebbings

et al. 2003

British Journal of Surgery

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“…In the present study, we established an animal model of constipation in rabbits using morphine, a μ ‐opioid agonist. It has been reported that morphine causes constipation by inhibiting gastrointestinal transit and intestinal secretion in animals and humans 27–30 . It is well known that morphine is widely used to relieve pain in patients with cancer, and the fact that it frequently causes constipation, and sometimes severe constipation, has long been recognized as a clinical problem 31,32 .…”

Section: Discussionmentioning

confidence: 99%

Mitemcinal (GM‐611), an orally active motilin agonist, facilitates defecation in rabbits and dogs without causing loose stools

Sudo¹,

Muramatsu²,

Kamei³

et al. 2007

Neurogastroenterology Motil

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The effects of mitemcinal (GM-611), an orally active motilin agonist, on defecation were investigated in rabbits and dogs. In normal rabbits, within 0-3 h of dosing, orally administered mitemcinal (2.5-10 mg kg(-1)) increased stool weight in a dose-dependent manner without causing loose stools. Sennoside (12-48 mg kg(-1)) also facilitated defecation within 2-9 h of oral administration, but the stools were significantly loosened. In the morphine-induced constipation model, the stool weight of morphine-treated rabbits (1 mg kg(-1)) was only 37.5% of that of untreated animals. Mitemcinal (0.5-20 mg kg(-1)) dose-dependently increased stool weight without increasing stool water content. At the highest dose of mitemcinal, stool weight recovered to 83.9% of that of untreated animals. In normal dogs, mitemcinal (0.3-3 mg kg(-1)) reduced the time to first bowel movement after oral administration without inducing diarrhoea at any dose. These results indicate that mitemcinal facilitates defecation without inducing severe diarrhoea. It is suggested that mitemcinal may be a novel therapeutic agent for constipation that enables easier control of the timing of defecation because of the early onset and short duration of its action, compared with sennoside.

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How Does Morphine Work on Colonic Motility? An Electromyographic Study in the Human Left and Sigmoid Colon

Cited by 10 publications

References 0 publications

Variability in serotonin and enterochromaffin cells in patients with colonic inertia and idiopathic diarrhoea as compared to normal controls

Variability in serotonin and enterochromaffin cells in patients with colonic inertia and idiopathic diarrhoea as compared to normal controls

Anti-inflammatory drugs, analgesics and the risk of perforated colonic diverticular disease

Mitemcinal (GM‐611), an orally active motilin agonist, facilitates defecation in rabbits and dogs without causing loose stools

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