Mo1300 Gallbladder Emptying in Relation to Gastric Emptying and CCK Release in Patients With Anorexia Nervosa

In a double-blind trial, 12 out-patients with primary anorexia nervosa received, for six weeks, either 10 mg cisapride or placebo, three times a day. Cisapride accelerated gastric emptying of a radiolabelled semisolid meal in all six patients; five gained weight and symptoms of gastric retention ameliorated in four. With placebo, three of six had emptying enhanced, four gained weight, and one's symptoms improved. For another six weeks, all patients received cisapride. In five of the patients who had received cisapride, emptying further accelerated or remained stable; in one it slowed. Of the six patients who received placebo, four had emptying accelerated, five gained weight, and symptoms improved in four. Longer administration of cisapride may, by enhancing gastric motor activity, alleviate symptoms of retention and thus help to change eating behaviour.

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Enhancement of intragastric acid stability of a fat emulsion meal delays gastric emptying and increases cholecystokinin release and gallbladder contraction

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00452.2006 ◽

2007 ◽

Vol 292 (6) ◽

pp. G1607-G1613 ◽

Cited By ~ 98

Author(s):

Luca Marciani ◽

Martin Wickham ◽

Gulzar Singh ◽

Debbie Bush ◽

Barbara Pick ◽

...

Keyword(s):

Gastric Emptying ◽

Emulsion Stability ◽

Fat Emulsion ◽

Acid Stability ◽

Gallbladder Contraction ◽

Oil Emulsion ◽

Gastric Lumen ◽

Intragastric Acid ◽

Acid Stable ◽

Cck Release

Preprocessed fatty foods often contain calories added as a fat emulsion stabilized by emulsifiers. Emulsion stability in the acidic gastric environment can readily be manipulated by altering emulsifier chemistry. We tested the hypothesis that it would be possible to control gastric emptying, CCK release, and satiety by varying intragastric fat emulsion stability. Nine healthy volunteers received a test meal on two occasions, comprising a 500-ml 15% oil emulsion with 2.5% of one of two emulsifiers that produced emulsions that were either stable ( meal A) or unstable ( meal B) in the acid gastric environment. Gastric emptying and gallbladder volume changes were assessed by MRI. CCK plasma levels were measured and satiety scores were recorded. Meal B layered rapidly owing to fat emulsion breakdown. The gastric half-emptying time of the aqueous phase was faster for meal B (72 ± 13 min) than for meal A (171 ± 35 min, P < 0.008). Meal A released more CCK than meal B (integrated areas, respectively 1,095 ± 244 and 531 ± 111 pmol·min·l−1, P < 0.02), induced a greater gallbladder contraction ( P < 0.02), and decreased postprandial appetite ( P < 0.05), although no significant differences were observed in fullness and hunger. We conclude that acid-stable emulsions delayed gastric emptying and increased postprandial CCK levels and gallbladder contraction, whereas acid-instability led to rapid layering of fat in the gastric lumen with accelerated gastric emptying, lower CCK levels, and reduced gallbladder contraction. Manipulation of the acid stability of fat emulsion added to preprocessed foods could maximize satiety signaling and, in turn, help to reduce overconsumption of calories.

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Regulation of gastric and pancreatic lipase secretion by CCK and cholinergic mechanisms in humans

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1997.273.2.g374 ◽

1997 ◽

Vol 273 (2) ◽

pp. G374-G380 ◽

Cited By ~ 7

Author(s):

J. Borovicka ◽

W. Schwizer ◽

C. Mettraux ◽

C. Kreiss ◽

B. Remy ◽

...

Keyword(s):

Gastric Emptying ◽

Pancreatic Lipase ◽

Random Order ◽

Dietary Lipids ◽

Cholinergic Mechanisms ◽

Mixed Meal ◽

Fat Digestion ◽

Gastric Lipase ◽

Cck Release

Gastric lipase (HGL) contributes significantly to fat digestion. However, little is known about its neurohormonal regulation in humans. We studied the role of CCK and cholinergic mechanisms in the postprandial regulation of HGL and pancreatic lipase (HPL) secretion in six healthy subjects. Gastric emptying of a mixed meal and outputs of HGL, pepsin, acid, and HPL were determined with a double-indicator technique. Three experiments were performed in random order: intravenous infusion of 1) placebo, 2) low-dose atropine (5 micrograms.kg-.h-1), and 3) the CCK-A receptor antagonist loxiglumide (22 mumol.kg-.h-1). Atropine decreased postprandial outputs of HGL, pepsin, gastric acid, and HPL (P < 0.03) while slowing gastric emptying (P < 0.05). Loxiglumide markedly increased the secretion of HGL, pepsin, and acid while distinctly reducing HPL outputs and accelerating gastric emptying (P < 0.03). Plasma CCK and gastrin levels increased during loxiglumide infusion (P < 0.03). Atropine enhanced gastrin but not CCK release. Postprandial HGL, pepsin, and acid secretion are under positive cholinergic but negative CCK control, whereas HPL is stimulated by cholinergic and CCK mechanisms. We conclude that CCK and cholinergic mechanisms have an important role in the coordination of HGL and HPL secretion to optimize digestion of dietary lipids in humans.

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Effect of oral CCK-1 agonist GI181771X on fasting and postprandial gastric functions in healthy volunteers

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00074.2004 ◽

2004 ◽

Vol 287 (2) ◽

pp. G363-G369 ◽

Cited By ~ 34

Author(s):

Emma Janet Castillo ◽

Silvia Delgado-Aros ◽

Michael Camilleri ◽

Duane Burton ◽

Debra Stephens ◽

...

Keyword(s):

Gastric Emptying ◽

Adverse Effects ◽

Single Photon ◽

Photon Emission ◽

Area Under The Curve ◽

Gastric Volume ◽

Oral Solution ◽

Gallbladder Emptying ◽

Double Blind ◽

Computed Tomographic

CCK influences satiation and gastric and gallbladder emptying. GI181771X is a novel oral CCK-1 agonist; its effects on gastric emptying of solids, accommodation, and postprandial symptoms are unclear. Effects of four dose levels of the oral CCK-1 agonist GI181771X and placebo on gastric functions and postprandial symptoms were compared in 61 healthy men and women in a randomized, gender-stratified, double-blind, double-dummy placebo-controlled, parallel group study. Effects of 0.1, 0.5, and 1.5 mg of oral solution and a 5.0-mg tablet of GI181771X on gastric emptying of solids by scintigraphy, gastric volume by 99mTc-single photon emission computed tomographic imaging, maximum tolerated volume of Ensure, and postprandial nausea, bloating, fullness, and pain were studied. On each of 3 study days, participants received their randomly assigned treatment. Adverse effects and safety were monitored. There were overall group effects of GI181771X on gastric emptying ( P < 0.01) and fasting and postprandial volumes ( P = 0.036 and 0.015, respectively). The 1.5-mg oral solution of GI181771X significantly delayed gastric emptying of solids ( P < 0.01) and increased fasting ( P = 0.035) gastric volumes without altering postprandial ( P = 0.056) gastric volumes or postprandial symptoms relative to placebo. The effect of the 5.0-mg tablet on gastric emptying of solids did not reach significance ( P = 0.052). Pharmacokinetic profiles showed the highest area under the curve over 4 h for the 1.5-mg solution and a similar area under the curve for the 0.5-mg solution and 5-mg tablet. Adverse effects were predominantly gastrointestinal and occurred in a minority of participants. GI181771X delays gastric emptying of solids and exhibits an acceptable safety profile in healthy participants. CCK-1 receptors can be modulated to increase fasting gastric volume.

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Influence of CCKA, CCKB antagonists on CCK8-induced satiety, gallbladder emptying and blockade of gastric emptying in the mouse

Regulatory Peptides ◽

10.1016/0167-0115(92)90244-o ◽

1992 ◽

Vol 40 (2) ◽

pp. 163 ◽

Cited By ~ 1

Author(s):

P.C. Gregory ◽

K.-U. Wolf ◽

C. Eeckhout ◽

H. Waldeck ◽

U. Preuschoff

Keyword(s):

Gastric Emptying ◽

Gallbladder Emptying ◽

Cckb Antagonists

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Endogenous cholecystokinin drives gallbladder emptying in dogs

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1986.251.4.g553 ◽

1986 ◽

Vol 251 (4) ◽

pp. G553-G558

Author(s):

K. Shiratori ◽

S. Watanabe ◽

W. Y. Chey ◽

K. Y. Lee ◽

T. M. Chang

Keyword(s):

Corn Oil ◽

Venous Blood ◽

Gallbladder Emptying ◽

Dependent Manner ◽

Gallbladder Volume ◽

Dose Dependent ◽

Intraduodenal Administration ◽

Different Doses ◽

Cck Release

We investigated the effect of fat in the duodenum on the gallbladder emptying in seven dogs prepared with gastric, duodenal, and gallbladder cannulas. Gallbladder volume was measured at 15-min intervals, and venous blood samples were obtained at regular intervals for 2.5 h. Intraduodenal administration of Lipomul (pH 5.0, corn oil) in three different doses (1.1, 2.2, and 4.4 mmol/10 min) resulted in significant increases in gallbladder emptying in a dose-dependent manner (r = 0.8668, P less than 0.001). Likewise, the increase in integrated cholecystokinin (CCK) release in response to Lipomul was also dose dependent (r = 0.7334, P less than 0.001). A statistically significant correlation was found between integrated CCK release and gallbladder emptying in response to Lipomul (P less than 0.001). To determine the role of circulating endogenous CCK on gallbladder emptying effects of intravenous administration of proglumide and a rabbit anti-CCK serum on gallbladder emptying were studied. Gallbladder emptying was virtually abolished by the antiserum. Proglumide not only abolished the emptying but also increased gallbladder volume. Thus we conclude that in dogs the gallbladder emptying in response to fat in the upper small intestine depends on increased circulating endogenous CCK.

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