Ameliorating effect of transcutaneous electroacupuncture on impaired gastric accommodation induced by cold meal in healthy subjects

After a meal, the proximal stomach relaxes probably through the activation of nitrergic neurons in the gastric wall. Nitric oxide-induced smooth muscle relaxation involves activation of soluble guanylate cyclase, with cGMP production, which is then degradated by phosphodiesterase-5 (PDE-5). The aim of this study was to investigate the effect of sildenafil, a selective PDE-5 inhibitor, on fasting and postprandial proximal gastric volume and on gastric emptying rates in humans. A gastric barostat was used to study gastric compliance and perception to isobaric distension in healthy subjects before and after placebo ( n = 13) or sildenafil, 50 mg ( n = 15). In 10 healthy subjects, two gastric barostat studies were performed in randomized order to study the effect of placebo or sildenafil on postprandial gastric relaxation. Similarly, solid and liquid gastric emptying rates were studied in 12 healthy subjects. Sildenafil significantly increased fasting intragastric volume (141 ± 15 vs. 163 ± 15 ml, P < 0.05) and volumes of first perception. Sildenafil induced a higher and prolonged gastric relaxation either at 30 min (357 ± 38 vs. 253 ± 42 ml, P < 0.05) or 60 min (348 ± 49 vs. 247 ± 38 ml, P < 0.05) after the meal. Sildenafil did not alter solid half-emptying time but significantly delayed liquid emptying (43 ± 4 vs. 56 ± 4 min, P < 0.01). In conclusion, sildenafil significantly increases postprandial gastric volume and slows liquid emptying rate, confirming that meal-induced accommodation in humans involves the activation of a nitrergic pathway. The effect of sildenafil on gastric fundus suggests a therapeutic potential for phosphodiesterase inhibitors in patients with impaired gastric accommodation.

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Influence of sumatriptan on gastric accommodation and on antral contraction in healthy subjects assessed by ultrasonography

Neurogastroenterology & Motility ◽

10.1111/j.1365-2982.2012.01984.x ◽

2012 ◽

Vol 24 (12) ◽

pp. 1083-e564 ◽

Cited By ~ 6

Author(s):

Y. Sekino ◽

E. Yamada ◽

E. Sakai ◽

H. Ohkubo ◽

T. Higurashi ◽

...

Keyword(s):

Healthy Subjects ◽

Gastric Accommodation

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Contribution of different triggers to the gastric accommodation reflex in humans

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00046.2009 ◽

2009 ◽

Vol 297 (5) ◽

pp. G902-G906 ◽

Cited By ~ 14

Author(s):

Pieter Vanden Berghe ◽

Pieter Janssen ◽

Sebastien Kindt ◽

Rita Vos ◽

Jan Tack

Keyword(s):

Healthy Subjects ◽

Gastric Retention ◽

Fixed Rate ◽

Proximal Stomach ◽

Gastric Accommodation ◽

Sham Feeding ◽

Early Satiety ◽

Cephalic Phase ◽

And Control ◽

Nasointestinal Tube

Accommodation of the stomach consists of a vagally mediated relaxation of the proximal stomach, providing the meal with a reservoir. Our aim was to study whether, similar to other vagally mediated processes, the accommodation reflex is also determined by cephalic, oropharyngeal, gastric, and intestinal phases. Eleven healthy subjects underwent in randomized order five gastric barostat studies and two satiety drinking tests. In all studies, isobaric tone measurements (at minimal distending pressure + 2 mmHg) were performed 20 min before and 20 min after a nutrient stimulus. The stimuli included only visual and olfactory exposure to a meal (cephalic stimulation), taking liquid nutrient in the mouth without swallowing (sham feeding), ingestion of a 200-ml 300-kcal nutrient meal with blocked outflow to the pylorus (gastric retention), and meal infusion through a nasointestinal tube (duodenal instillation), or normal ingestion (control). During satiety testing, subjects ingested liquid nutrient at a fixed rate of 15 ml/min until maximum satiety, with an inflated or deflated intrapyloric balloon assembly. Progressively bigger gastric relaxatory responses were seen with cephalic stimulation (18 ± 19 ml), sham feeding (54 ± 21 ml), gastric retention (95 ± 47), duodenal instillation (144 ± 33), and control (232 ± 33 ml). The amount of nutrient ingested at maximum satiety was significantly lower with an inflated intrapyloric balloon (1,223 ± 103 vs. 1,392 ± 124 ml, P < 0.05). The accommodation reflex in humans lacks a cephalic phase, but it can be activated from the oropharynx, the stomach, and the duodenum. Blocking passage to the duodenum significantly decreases the amplitude of the accommodation reflex and induces early satiety.

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The effect of mirtazapine on gastric accommodation, gastric sensitivity to distention, and nutrient tolerance in healthy subjects

Neurogastroenterology & Motility ◽

10.1111/nmo.13146 ◽

2017 ◽

Vol 29 (12) ◽

pp. e13146 ◽

Cited By ~ 15

Author(s):

F. Carbone ◽

T. Vanuytsel ◽

J. Tack

Keyword(s):

Healthy Subjects ◽

Gastric Accommodation ◽

Gastric Sensitivity

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Influence of duodenal acidification on the sensorimotor function of the proximal stomach in humans

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00086.2003 ◽

2004 ◽

Vol 286 (2) ◽

pp. G278-G284 ◽

Cited By ~ 87

Author(s):

Kwang-Jae Lee ◽

Rita Vos ◽

Jozef Janssens ◽

Jan Tack

Keyword(s):

Healthy Subjects ◽

Gastric Fundus ◽

Acid Exposure ◽

Gastric Distension ◽

Gastric Accommodation ◽

Double Blind ◽

Gastric Tone ◽

Acid Infusion ◽

Duodenal Acidification ◽

Double Blind Design

Decreased acid clearance and increased exposure to acid of the duodenum have been reported in a subset of functional dyspepsia patients. However, the mechanism by which increased duodenal acid exposure may affect symptoms is unclear. The aim of the present study was to investigate the effects of duodenal acidification on proximal gastric tone and mechanosensitivity in humans. An infusion tube with a pH electrode attached was positioned in the second part of the duodenum, and a barostat bag was located in the gastric fundus. In 12 healthy subjects, fundic tone and sensitivity to distensions were assessed before and during duodenal infusion of 0.1 N hydrochloric acid or saline in a randomized, double-blind design. In 10 healthy subjects, meal-induced accommodation was measured during duodenal infusion of acid or saline. Acid infusion in the duodenum significantly increased fundic compliance and decreased fasting fundic tone. This was accompanied by a significant decrease in the pressures and the corresponding wall tensions at the thresholds for discomfort. During infusion of acid, significantly higher perception and symptom scores were obtained for the same distending pressures. The meal-induced fundic relaxation was significantly smaller during acid infusion compared with saline infusion. In conclusion, duodenal acidification induces proximal gastric relaxation, increases sensitivity to gastric distension, and inhibits gastric accommodation to a meal. Through these mechanisms, increased duodenal acid exposure may be involved in the pathogenesis of dyspeptic symptoms.

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