Gastric emptying and antral motility in reflux esophagitis

AbstractClostridium (C.) ventriculi (known as Sarcina ventriculi) is a ubiquitous gram-positive, anaerobic, acidophilic coccus found in patients with gastric motility disorders. The microorganisms can be identified histologically by their characteristic presentation in tetrads or packets of 8 in hematoxylin and eosin stains. Severe cases of emphysematous gastritis or gastric perforation have been described. Nevertheless, the significance of C. ventriculi in an upper gastrointestinal tract and its pathogenic character remain unclear. We present a 67-year-old woman who underwent hiatoplasty with gastropexy. After 3 months, she underwent a gastroscopy showing gastroesophageal reflux. Biopsies showed ulcerative reflux esophagitis with presence of C.ventriculi, subsequently confirmed by 16S ribosomal RNA gene amplicon sequencing. The barium swallow study revealed an atonic stomach with delayed gastric emptying. The patient was treated with PPI and domperidone. On follow up, 15 months post-operatively, a control gastroscopy showed a stomach with food residues and reflux-associated small erosions. The Clostridium organisms were detected only in oxyntic mucosa biopsies without erosions or ulcerations. We speculate that the recognition of the organisms in the biopsy material is important and suggests dysmotility disorder. However, in our opinion, the presence of C. ventriculi, even in combination with mucosal damage, does not necessarily prompt antibiotic treatment since no complications occurred and inflammation as well as gastric function improved under PPI and prokinetic therapy in our patient. Larger study groups with long-term follow-up are needed to understand whether these organisms could behave as pathogens or are only bystanders in the setting of delayed gastric emptying.

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The control mechanisms of gastric emptying are not overridden by motor stimulants

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1986.251.6.g744 ◽

1986 ◽

Vol 251 (6) ◽

pp. G744-G751 ◽

Cited By ~ 2

Author(s):

S. Wulschke ◽

H. J. Ehrlein ◽

C. Tsiamitas

Keyword(s):

Gastric Emptying ◽

Gastrointestinal Motility ◽

Control Mechanisms ◽

Wall Tension ◽

Physiological Conditions ◽

Duodenal Motility ◽

Antral Motility

We wanted to determine if an acceleration of the normal emptying rate by motor stimulants interfers with control mechanisms limiting gastric emptying. Therefore, we studied the effects of 5-hydroxytryptophane (5-HTP) and cisapride on canine gastrointestinal motility and gastric emptying after ingestion of viscous acaloric and nutritive meals. Prolonged contractions and relaxations that change lumen size (isotonic component) and wall tension (isometric component) are defined as “basal contractions” and “basal relaxations”, respectively. The nutrient meal emptied much slower than the acaloric meal due to several alterations of gastric, pyloric, and duodenal motility. Both drugs stimulated antral motility but failed to accelerate gastric emptying of the nutrient meal. The main causes for the failure were a basal relaxation of the proximal antrum and a basal contraction of the duodenum. In conclusion, basal contractions of the proximal antrum and duodenum play an important role in the process of gastric emptying, and under physiological conditions the control mechanisms of gastric emptying provide an optimal emptying rate that cannot be markedly accelerated by 5-HTP and cisapride.

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Delayed gastric emptying rates and impaired antral motility in children fulfilling Rome III criteria for functional abdominal pain

Neurogastroenterology & Motility ◽

10.1111/j.1365-2982.2011.01871.x ◽

2012 ◽

Vol 24 (5) ◽

pp. 420-425 ◽

Cited By ~ 30

Author(s):

N. M. Devanarayana ◽

S. Rajindrajith ◽

N. Rathnamalala ◽

S. Samaraweera ◽

M. A. Benninga

Keyword(s):

Abdominal Pain ◽

Gastric Emptying ◽

Delayed Gastric Emptying ◽

Rome Iii Criteria ◽

Functional Abdominal Pain ◽

Antral Motility ◽

Rome Iii

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PTH-035 Assessment of gastric emptying and antral motility in different types of abdominal pain related functional gastrointestinal diseases: a paediatric study: Abstract PTH-035

Gut ◽

10.1136/gut.2009.209023v ◽

2010 ◽

Vol 59 (Suppl 1) ◽

pp. A136.3-A137

Author(s):

N M Devanarayana ◽

S Rajindrajith

Keyword(s):

Abdominal Pain ◽

Gastric Emptying ◽

Gastrointestinal Diseases ◽

Paediatric Study ◽

Antral Motility ◽

Different Types ◽

Functional Gastrointestinal Diseases

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Electroacupuncture at ST36 Improve the Gastric Motility by Affecting Neurotransmitters in the Enteric Nervous System in Type 2 Diabetic Rats

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6666323 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Xu Han ◽

Xiaoyan Chen ◽

Xuan Wang ◽

Meirong Gong ◽

Mengjiang Lu ◽

...

Keyword(s):

Nervous System ◽

Body Weight ◽

Blood Glucose ◽

Gastric Emptying ◽

Food Intake ◽

Enteric Nervous System ◽

The Body ◽

Antral Motility ◽

Excitatory Neurotransmitters

Electroacupuncture (EA) can effectively relieve hyperglycemia and gastric emptying disorders in diabetic gastroparesis (DGP). However, the effect of EA on type 2 diabetes mellitus (T2DM) gastroparesis and its mechanism in the enteric nervous system (ENS) are rarely studied. We investigated the therapeutic effect of EA at ST36 and its effect on the main inhibitory and excitatory neurotransmitters in the ENS in DGP rats. Male Sprague-Dawley (SD) rats were fed a high-fat diet for 2 weeks and injected with streptozotocin (STZ) at 35 mg/kg to induce T2DM. T2DM rats were divided into the diabetic mellitus (DM) group and the EA group. The control (CON) group comprised normal rats without any intervention. EA treatment was started 6 weeks after the induction of DM and continued for 5 weeks. The body weight and food intake of the rats were recorded every week. Blood glucose, insulin, glucose tolerance, gastric emptying, and antral motility were measured after treatment. The expression of protein gene product 9.5 (PGP9.5), neuronal nitric oxide synthase (nNOS), and choline acetyltransferase (ChAT) in gastric antrum were quantified by western blotting and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). The T2DM gastroparesis model was successfully established. EA treatment reduced the body weight, food intake, and blood glucose; improved glucose intolerance and insulin resistance; increased the gastric emptying rate, the mean antral pressure, and the amplitude of antral motility; and decreased the frequency of antral motility compared with those in the DM group. EA treatment increased the expression level of nNOS, ChAT, and PGP9.5 proteins, and nNOS and ChAT mRNA. The results suggested that EA at ST36 could ameliorate DGP, partly restore the damage to general neurons, and increase nNOS and ChAT in the gastric antrum. EA improved DGP partly via reducing the loss of inhibitory and excitatory neurotransmitters in the ENS.

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