Intragastric acidification inhibits motilin‐induced phase III activity in humans

Abstract

In a randomized, placebo-controlled crossover design we studied the effect of gastric acidification on motilin-induced interdigestive antropyloroduodenal motility. Ten healthy volunteers participated in the study consisting of four experiments. Each experiment started after a spontaneous occurring phase III and consisted of intragastric infusion of either saline or acid (0.08 mol L(-1) HCl) for 90 min and intravenous infusion of either saline or motilin (4 pmol kg(-1) min(-1)) for 30 min. Antropyloroduodenal motility and pH were recorded continuously for 240 min. Reoccurrence of phase III was significantly (P < 0.05) earlier during intragastric saline-intravenous motilin infusion compared with control (intragastric saline-intravenous saline), 52 min (range 25-79) and 113 min (84-141) respectively. This effect was completely abolished during intragastric acid-intravenous motilin infusion, 112 min (82-142). The percentage of phase III of antral origin was significantly (P < 0.05) higher during intragastric saline-intravenous motilin infusion (90%) compared with control (30%). The mean area under the contraction (AUC) for phase II was significantly (P < 0.05) lower during intragastric saline-intravenous motilin infusion and intragastric acid-intravenous saline infusion compared with control. It is concluded that in humans intragastric acidification inhibits the effect of motilin on antroduodenal motility, decreases the AUC of antral phase II contractions and delays the occurrence of phase III of the migrating motor complex.

Propagation Characteristics of Fasting Duodeno-Jejunal Contractions in Healthy Controls Measured by Clustered Closely-spaced Manometric Sensors

“…The 48% rate of antral complex origin, 157 minute intervals between complex onset, 10.92 cycles/min contractile frequencies, and 3.72-4.68 cm/min propagation velocities are similar to previous values. 7,8,[11][12][13][14][15][17][18][19]26,31 Our 6.99 minute complex durations were slightly longer than prior studies. 8,[14][15][16][17][18][19]24,26,31 This study provides new information on factors affecting phase III morphology.…”

“…2,5,6 Semiquantitative parameters can be gleaned from traditional intestinal manometry recordings in adults and children including phase III periodicity, antral versus duodenal site of phase III origin, phase III duration and frequency, phase III complex propagation velocity, and contractile amplitudes. [7][8][9][10][11][12][13][14][15][16][17][18][19] As stated by others, clinical use of small bowel manometry has been limited by few measurement points with long distances between sensors. 6 Nevertheless, use of such methods has had positive impacts on patient management in retrospective series including decisions to change medication treatments or nutritional regimens.…”

Relationship between Gastric Stasis in the Remnant Stomach and Interdigestive Migrating Complex in Patients after Pylorus-Preserving Gastrectomy for Gastric Cancer

“…IMC acts as an intestinal housekeeper, clearing residual food in addition to intestinal mucosa shedding in the intestinal lumen, gastric, intestinal, and pancreatic juice, and bile, and making the gastrointestine ready for food intake [7] [8]. A decreased frequency of IMC occurrence thus induces symptoms of retention of gastric content such as gastric juice secreted at the interdigestive state and residual food, and symptoms due to excessive proliferation of bacteria resulting from the lack of the housekeeper effect in the remnant stomach and small intestine, leading to PAF due to GSRS [22] [23]. We think that, when gastrointestinal motility after PPG becomes abnormal, proper physiological functioning such as interdigestive and postprandial digestion and absorption may naturally become impossible, leading to the occurrence of abdominal symptoms in association with food intake (e.g., loss of appetite, PAF, abdominal distention, and GSRS after PPG).…”

Review article: the diagnosis and management of gastroparesis

“…Antroduodenal manometry requires a water‐perfused or solid‐state catheter that measures intraluminal pressures in the stomach and small intestine. To determine pyloric function, a challenging method is required, a so‐called pyloric sleeve is included in a water‐perfused catheter assembly and transmucosal potential difference measurement is used to determine adequate positioning of the sleeve across the pyloric sphincter 48 . Current development in high resolution manometry systems and the possibility to present data as contour plots might simplify measurement of pyloric function 49 …”