Interdigestive Gastroduodenal Motor Activity in Subjects with Increased Gastric Acid Secretion

Bortolotti, Mauro; Barbara, L

doi:10.1159/000199768

Cited by 17 publications

(23 citation statements)

References 8 publications

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“…Gastroduodenal motility was recorded by means of a 6-lumen manometric probe with lateral holes 5 cm part indicated by radiopaque markers following a method described in detail elsewhere [4], The cath eters were perfused with an Artidorfer pump (Arndorfer Medical Specialties, Greendale, Wise., USA) and connected to Statham P-23 Db external pressure transducers (Statham Laboratories Inc., Puerto Rico) and to a Beckman R 612 polygraph (Beckman Instru ments, Schiller Park, III.). After an overnight fasting of 14 h the manometric probe was positioned under radiologic control with one recording hole in the gas tric corpus, two in the gastric antrum, and three in the proximal duodenum.…”

Section: Methodsmentioning

confidence: 99%

“…In normal subjects the interdigestive gas troduodenal motility is inhibited by acid, either it is infused intraluminally [1,2], or increased by sham feeding [3], We have ob served that in hypersecretory duodenal ulcer the cyclic gastroduodenal motility shows a lower-than-normal frequency and duration of activity fronts of the migrating motor complex (MMC) [4], This motor pattern is similar to that observed in other hypersecre tory states either spontaneous and induced by secretagogues [4], Although controversy exists about a direct relationship between ulcer activity and acid secretion [5][6][7], the existence of a consistent proportion of duo denal ulcer patients, who share an increase in acid secretion during ulcer reactivation and a decrease during remission, cannot be denied. Consequently, the increase in acid secretion that would take place during ulcer activity in these patients should inhibit gas troduodenal motility, whereas the normal ization of acid secretion during the remis sion of the ulcer disease should be associated to a normalization of the cyclic motility.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Interdigestive Gastroduodenal Motility in Patients with Active and Inactive Duodenal Ulcer Disease

Bortolotti¹,

Pinotti²,

Sarti³

et al. 1989

Digestion

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The interdigestive gastroduodenal motility was studied by means of a manometric probe in 6 patients with active duodenal ulcer and acid hypersecretion, in 6 patients with ulcer disease in remission (inactive) and normosecretion and in 8 healthy subjects with normosecretion. After a basal recording period sufficient to record at least two activity fronts of the migrating motor complex (MMC), an intraluminal infusion of isotonic NaHCO₃ was carried out for 180 min in patients with active duodenal ulcer, whereas in patients with ulcer in remission an HCl solution was infused for 180 min. Patients with active duodenal ulcer showed a basal motility with a longer than normal MMC cycle and a shorter than normal activity front, while patients with ulcer in remission showed a cyclic motor activity not significantly different from that of normal subjects. The NaHCO₃ infusion in patients with active ulcer restored a near-normal motility, whereas the HCl infusion in patients with ulcer in remission induced a motility similar to that of patients with active ulcer. These data indicate that the increase in gastric acid secretion is responsible for the decrease in frequency and duration of MMC activity fronts, which have the function of cyclically clearing the gastroduodenal lumen. Consequently, acid and bacteria may remain a longer than normal time in contact with the gastroduodenal mucosa, which, in this manner, may be greatly exposed to the risk of peptic lesions.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Interdigestive Gastroduodenal Motility in Patients with Active and Inactive Duodenal Ulcer Disease

Bortolotti¹,

Pinotti²,

Sarti³

et al. 1989

Digestion

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“…In the fasted state, acid suppression increases phase 3 migrating motor complex (MMC) activity (‘housekeeping contractions’ that clear the bowel of undigested debris), whereas stimulating gastric acid secretion decreases MMC activity [10, 11]. This is likely due to alkaline pH in the duodenum triggering this contraction pattern [10].…”

Section: Gastric Acid and Motilitymentioning

confidence: 99%

“…Studies have shown that intravenous infusion of gastrin increases antral activity and delays gastric emptying [16]. Moreover reduced gastric secretion volume on H 2 RAs or PPIs would also be expected to slow gastric emptying [11]. However, the relative importance of acid suppression on secretion volume and motility with regard to gastric emptying is unknown.…”

Section: Gastric Acid and Motilitymentioning

confidence: 99%

Do We Need Gastric Acid?

et al. 2008

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Evidence from comparative anatomy and physiology studies indicates that gastric acid secretion developed during the evolution of vertebrates approximately 350 million years ago. The cellular mechanisms that produce gastric acid have been conserved over the millennia and therefore proton pump inhibitors have pharmacological effects in almost all relevant species. These observations suggest that gastric acid provides an important selective advantage; however, in modern-day humans the need for gastric acid can be questioned in light of the widespread use of safe and effective pharmacologic acid suppression. The Kandahar Working Group addressed questions concerning the need, production and effects of gastric acid, specifically: (1) motility in the upper gastrointestinal (GI) tract; (2) neuroendocrine factors; (3) digestive and mucosal processes; (4) microbiology, and (5) central processes and psychological involvement. We addressed each topic with the individual models available to answer our questions including animal versus human studies, pharmacologic, surgical as well as pathophysiologic states of acid suppression.

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“…Meals induce irregular contractions for a considerable period of time postprandially, and the quiescent phase (phase I) begins after the meal activity has subsided. Age-related changes have been documented, but not until the eighth or ninth decade of life (4). Patterns of small bowel motility in older adults have been documented via ambulatory manometry monitoring by Husebye and Engedahl (11).…”

Section: Gastric and Small Bowel Motilitymentioning

confidence: 99%

IV. Clinical and physiological aspects of gastrointestinal motility and aging

Orr

Chen²

2002

American Journal of Physiology-Gastrointestinal and Liver Physi

100

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Control of the GI Tract. IV. Clinical and physiological aspects of gastrointestinal motility and aging. Am J Physiol Gastrointest Liver Physiol 283: G1226-G1231, 2002; 10.1152/ajpgi.00276. 2002.-The gastrointestinal motility changes that occur as a function of age are reviewed herein. Careful attention must be given in any review of aging phenomena to exclude, or at least be cognizant of, the many comorbid conditions that can alter physiological functioning in older adults. The dramatic increase in life expectancy over the past 10-15 years demands that clinicians be aware of the various physiological and clinically relevant changes that occur with age. Gastrointestinal motility changes associated with age are relatively subtle, and in many instances only conflicting data exist. As the older adult population increases, and as the control of disease is improved, much more work needs to be done to understand the true effects of aging on gastrointestinal functioning.gastroesophageal reflux disease; dysphagia; lower esophageal sphincter; incontinence LIFE EXPECTANCY HAS INCREASED dramatically over the past 10-15 years, and the population of individuals over 65 yr old is expected to more than double by the year 2050. The projected rise in the number of Americans over the age of 85 yr is expected to increase from 4 to 18 million over a similar interval of time. As life span increases, the probability increases that individuals will acquire chronic and debilitating diseases such as osteoarthritis, Parkinson's disease, and other neurological conditions, and the risk of stroke and its debilitating sequelae is also increased. These conditions are all associated with gastrointestinal (GI) complications, particularly those related to the esophagus and swallowing. Thus age-related changes in GI functioning can be categorized in terms of those associated with these comorbid conditions of aging or those associated with the aging process itself.Relatively little work has been done to describe the GI changes associated with aging, largely due to the invasive nature of the procedures required. Thus in many instances there is a dearth of normative data on which to base clinical comparisons. For example, very little work has been done to describe normal colonic functioning, and only a few studies have been published that described normative parameters of esophageal peristalsis and lower esophageal sphincter (LES) functioning. Similar limitations apply to gastric and small bowel functioning. Studies that have been done commonly reveal conflicting results due to differences in the technology used (i.e., manometric vs. radiographic). In addition, the manometric techniques that are used vary considerably, with only the more recent studies using intraluminal solid-state transducers, which allow a much more sophisticated assessment of pressure changes compared with those that were acquired or described using more conventional and commonly applied perfusion pressure technology. These issues preclude definitive statements regarding GI func...

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Interdigestive Gastroduodenal Motor Activity in Subjects with Increased Gastric Acid Secretion

Cited by 17 publications

References 8 publications

Interdigestive Gastroduodenal Motility in Patients with Active and Inactive Duodenal Ulcer Disease

Interdigestive Gastroduodenal Motility in Patients with Active and Inactive Duodenal Ulcer Disease

Do We Need Gastric Acid?

IV. Clinical and physiological aspects of gastrointestinal motility and aging

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