The nescience and nascence of gastrointestinal motility research in acute pancreatitis

Petrov, Maxim S.

doi:10.1080/00365521.2017.1296182

Cited by 10 publications

(3 citation statements)

References 15 publications

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“…All scores were calculated in line with the original Gastroparesis Cardinal Symptom Index (GCSI) questionnaire, previously validated in the setting of acute pancreatitis [19,20]. The total GCSI score was calculated from the mean of 3 subscale scores (nausea/vomiting, bloating, and early satiety), resulting in a maximum possible score of 5.…”

Section: Gastroparesis Cardinal Symptom Indexmentioning

confidence: 99%

Gut Hormone Responses to Mixed Meal Test in New-Onset Prediabetes/Diabetes After Acute Pancreatitis

et al. 2018

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The study was aimed to investigate gut hormone responses to mixed meal test in individuals with new-onset prediabetes or diabetes after acute pancreatitis (cases) compared with healthy controls, and the effect of body fat parameters. A total of 29 cases and 29 age- and sex-matched healthy controls were recruited. All participants were given standard mixed meal drink and blood samples were collected to measure dipeptidyl peptidase IV, gastric inhibitory peptide, glucagon like peptide-1, insulin, oxyntomodulin, and peptide YY. Body fat parameters were measured using magnetic resonance imaging. Repeated measures and linear regression analyses were conducted in unadjusted and adjusted models. Gastric inhibitory peptide levels were significantly higher whereas oxyntomodulin levels were significantly lower in cases compared with controls in both the unadjusted (p<0.001 and p<0.001, respectively) and adjusted (p<0.001 and p<0.001, respectively) models. In cases, liver fat % contributed up to 13.4% (vs. 2.9% in controls) to variance in circulating levels of gastric inhibitory peptide whereas body mass index - up to 20.8% (vs. 9.9% in controls) in circulating levels of oxyntomodulin. New-onset prediabetes/diabetes after acute pancreatitis is characterised by increased levels of gastric inhibitory peptide and decreased levels of oxyntomodulin. Further, liver fat % and body mass index appear to be the body fat parameters that contribute most significantly to gastric inhibitory peptide and oxyntomodulin levels, respectively.

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Section: Gastroparesis Cardinal Symptom Indexmentioning

confidence: 99%

Gut Hormone Responses to Mixed Meal Test in New-Onset Prediabetes/Diabetes After Acute Pancreatitis

et al. 2018

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“…Acute pancreatitis (AP), the localized pancreatic and systemic inflammation, is associated with severe complications. Gastrointestinal (GI) dysmotility, highly prevalent in AP patients, 1,2 results in symptoms of bloating, nausea, vomiting, and prolonged first defecation time. It is highly associated with excessive reproduction and translocation of gut flora and endotoxin, and can further aggravate the systemic inflammation manifested as the systemic inflammatory response syndrome (SIRS).…”

Section: Introductionmentioning

confidence: 99%

Integrative effects of transcutaneous electrical acustimulation on abdominal pain, gastrointestinal motility, and inflammation in patients with early‐stage acute pancreatitis

Xuan

Zhu

et al. 2021

Neurogastroenterology Motil

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Background/Aims Gastrointestinal (GI) dysmotility in acute pancreatitis (AP) aggravates inflammation and results in severe complications. This study aimed to explore effects and possible mechanisms of transcutaneous electrical acustimulation (TEA) on abdominal pain, GI dysmotility, and inflammation in AP patients. Methods Forty‐two AP patients were blindly randomized to receive TEA (n = 21) at acupoints PC6 and ST36 or Sham‐TEA (n = 21) at sham points for 2 days. Symptom scores, gastric slow waves, autonomic functions (assessed by spectral analysis of heart rate variability), circulatory levels of motilin, ghrelin, and TNF‐α were measured before and after the treatment. Sixteen healthy controls (HCs) were also included without treatment for the assessment of gastric slow waves and biochemistry. Key Results Compared with Sham‐TEA, TEA decreased abdominal pain score (2.57 ± 1.78 vs. 1.33 ± 1.02, p < 0.05), bloating score (5.19 ± 1.21 vs. 0.76 ± 0.99, p < 0.001), the first defecation time (65.79 ± 19.51 h vs. 51.38 ± 17.19 h, p < 0.05); TEA, but not Sham‐TEA, improved the percentage of normal gastric slow waves by 41.6% (p < 0.05), reduced AP severity score (5.52 ± 2.04 vs. 3.90 ± 1.90, p < 0.05) and serum TNF‐α (7.59 ± 4.80 pg/ml vs. 4.68 ± 1.85 pg/ml, p < 0.05), and upregulated plasma ghrelin (0.85 ± 0.96 ng/ml vs. 2.00 ± 1.71 ng/ml, p = 0.001) but not motilin (33.08 ± 22.65 pg/ml vs. 24.12 ± 13.95 pg/ml, p > 0.05); TEA decreased sympathetic activity by 15.0% and increased vagal activity by 18.3% (both p < 0.05). Conclusions & Inferences TEA at PC6 and ST36 administrated at early stage of AP reduces abdominal pain, improves GI motility, and inhibits inflammatory cytokine, TNF‐α, probably mediated via the autonomic and ghrelin mechanisms.

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“…Gastric emptying per se has not been investigated in the context of AP [24], however a 2014 meta-analysis showed that gastrointestinal dysfunction (in the form of gut barrier dysfunction) develops in nearly 60 % of AP patients during admission for AP [25]. While clinical studies on gastroparesis in AP patients during hospitalisation have started to emerge [26][27][28][29], gastrointestinal motility has never been investigated in individuals after an episode of AP (let alone DM in the context of AP) [24,30].…”

Section: Introductionmentioning

confidence: 99%

Elevated Circulating Levels of Motilin are Associated with Diabetes in Individuals after Acute Pancreatitis

Gold-Smith

Singh

Petrov

2019

Exp Clin Endocrinol Diabetes

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Aim The study aimed to investigate the associations between glycaemic control after acute pancreatitis and gastrointestinal motility, using plasma motilin concentration and gastroparesis cardinal symptom index score as proxies. Methods This cross-sectional study recruited a total of 93 individuals after acute pancreatitis. Gastroparesis cardinal index scores, demographic and anthropometric factors, as well as pancreatitis-related factors were analysed. Fasting venous blood was collected to measure motilin, glycated haemoglobin, and fasting blood glucose. Linear regression analyses were conducted to investigate the associations between glycaemic control and gastrointestinal motility in unadjusted and adjusted models. Results Motilin was significantly higher in individuals with diabetes across all adjusted models, with the highest ß-coefficient (95% confidence interval) of 588.89 (138.50, 1039.28); P=0.010. Fasting blood glucose was significantly associated with motilin across all models, with the highest ß-coefficient (95% confidence interval) of 156.30 (55.49, 257.10); P=0.002. Glycated haemoglobin was significantly associated with motilin in one adjusted model with ß-coefficient (95% confidence interval) of 18.78 (1.53, 36.02); P=0.033. Gastroparesis cardinal symptom index was not significantly associated with any measure of glycaemic control. Conclusions Diabetes in individuals after acute pancreatitis appears to be characterised by elevated plasma motilin but not gastroparesis cardinal symptom index. The role of motilin in this setting warrants further investigations.

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The nescience and nascence of gastrointestinal motility research in acute pancreatitis

Cited by 10 publications

References 15 publications

Gut Hormone Responses to Mixed Meal Test in New-Onset Prediabetes/Diabetes After Acute Pancreatitis

Gut Hormone Responses to Mixed Meal Test in New-Onset Prediabetes/Diabetes After Acute Pancreatitis

Integrative effects of transcutaneous electrical acustimulation on abdominal pain, gastrointestinal motility, and inflammation in patients with early‐stage acute pancreatitis

Elevated Circulating Levels of Motilin are Associated with Diabetes in Individuals after Acute Pancreatitis

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