Effect of gastric acid suppressants on human gastric motility

Background—The effect of histamine H2receptor antagonists on gastric emptying is controversial.Aims—To determine the effects of ranitidine, famotidine, and omeprazole on gastric motility and emptying.Patients and methods—Fifteen normal subjects underwent simultaneous antroduodenal manometry, electrogastrography (EGG), and gastric emptying with dynamic antral scintigraphy (DAS). After 30 minutes of fasting manometry and EGG recording, subjects received either intravenous saline, ranitidine, or famotidine, followed by another 30 minutes recording and then three hours of postprandial recording after ingestion of a radiolabelled meal. Images were obtained every 10–15 minutes for three hours to measure gastric emptying and assess antral contractility. Similar testing was performed after omeprazole 20 mg daily for one week.Results—Fasting antral phase III migrating motor complexes (MMCs) were more common after ranitidine (9/15 subjects, 60%), famotidine (12/15, 80%), and omeprazole (8/12, 67%) compared with placebo (4/14, 29%; p<0.05). Postprandially, ranitidine, famotidine, and omeprazole slowed gastric emptying, increased the amplitude of DAS contractions, increased the EGG power, and increased the antral manometric motility index.Conclusions—Suppression of gastric acid secretion with therapeutic doses of gastric acid suppressants is associated with delayed gastric emptying but increased antral motility.

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Cholinergic effects on human gastric motility

Gut ◽

10.1136/gut.45.3.346 ◽

1999 ◽

Vol 45 (3) ◽

pp. 346-354 ◽

Cited By ~ 71

Author(s):

H P Parkman ◽

D M Trate ◽

L C Knight ◽

K L Brown ◽

A H Maurer ◽

...

Keyword(s):

Gastric Emptying ◽

Gastric Motility ◽

Normal Subjects ◽

Cholinergic Stimulation ◽

Gastric Myoelectrical Activity ◽

Solid Meal ◽

Myoelectrical Activity ◽

Motility Index ◽

Antroduodenal Manometry ◽

Cholinergic Effects

BACKGROUNDCholinergic regulation of chronotropic (frequency) and inotropic (force) aspects of antral contractility and how these impact on gastric emptying are not well delineated.AIMSTo determine the effects of cholinergic stimulation and inhibition on myoelectric, contractile, and emptying parameters of gastric motility.METHODSTen normal subjects underwent three studies each, using simultaneous electrogastrography (EGG), antroduodenal manometry, and gastric emptying with dynamic antral scintigraphy (DAS). After 30 minutes of baseline fasting manometry and EGG, subjects received saline intravenously, atropine (0.6 mg then 0.25 mg/hour intravenously), or bethanechol (5 mg subcutaneously). This was followed by another 30 minutes’ recording and by three hours of postprandial recording after ingestion of a technetium-99m labelled solid meal.RESULTSDuring fasting, atropine decreased, whereas bethanechol increased, the antral manometric motility index and EGG power. Postprandially, atropine decreased the amplitude of antral contractions by DAS, decreased the postprandial antral manometric motility index, and slowed gastric emptying. Atropine caused a slight increase in postprandial frequency of antral contractions by DAS and gastric myoelectrical activity by EGG. Bethanechol slightly increased the amplitude, but slightly decreased the frequency of antral contractions by DAS and decreased the frequency of gastric myoelectrical activity by EGG, with no significant increase in the motility index or gastric emptying.CONCLUSIONSCholinergic antagonism with atropine reduces antral contractility and slows gastric emptying. Cholinergic stimulation with bethanechol increases antral contractility, but decreases the frequency of antral contractions, without altering the antral motility index or gastric emptying.

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Dual effects of cisapride on gastric emptying and antropyloroduodenal motility

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1993.264.2.g195 ◽

1993 ◽

Vol 264 (2) ◽

pp. G195-G201 ◽

Cited By ~ 5

Author(s):

R. Fraser ◽

M. Horowitz ◽

A. Maddox ◽

J. Dent

Keyword(s):

Gastric Emptying ◽

Healthy Volunteers ◽

Gastric Motility ◽

Normal Subjects ◽

Solid Component ◽

Pressure Waves ◽

Dual Effect ◽

Intravenous Saline ◽

Plausible Mechanism ◽

Stimulation Of

There is little information about the effects of cisapride on human antropyloroduodenal motility, despite its documented efficacy for increasing the rate of gastric emptying in patients with gastroparesis. Cisapride has been reported to have little effect on gastric emptying in normal subjects. Antral, pyloric, and duodenal pressures were recorded simultaneously with gastric emptying in 20 healthy volunteers. Thirty minutes after the solid component of the meal had started to empty from the stomach, each subject received either 10 mg cisapride i.v. (11 subjects) or intravenous saline (9 subjects). Intravenous saline had no effect on either motility or gastric emptying. In contrast, cisapride administration was associated with a dual effect on motility, with initial suppression of antral pressure waves (P < 0.05) followed by stimulation of associated antropyloroduodenal pressure waves (P < 0.01). Gastric emptying slowed in the first 30 min after cisapride (P < 0.05), and this was followed by more rapid gastric emptying (P < 0.01). The amount of the meal emptied in the 60 min after cisapride correlated with the number of associated antroduodenal pressure waves (r = 0.75, P < 0.001) but not with the number of antral waves (r = 0.42, NS). These results indicate that cisapride in a dose of 10 mg i.v. has dual effects on gastric emptying and gastric motility. The stimulation of associated antral pressure waves is a plausible mechanism for the efficacy of cisapride in the treatment of gastroparesis.

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Effects of repeated restraint stress on gastric motility in rats

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.90928.2008 ◽

2009 ◽

Vol 296 (5) ◽

pp. R1358-R1365 ◽

Cited By ~ 68

Author(s):

Jun Zheng ◽

Anthony Dobner ◽

Reji Babygirija ◽

Kirk Ludwig ◽

Toku Takahashi

Keyword(s):

Gastric Emptying ◽

Chronic Stress ◽

Gastric Motility ◽

Restraint Stress ◽

Delayed Gastric Emptying ◽

Acute Stress ◽

Plasma Corticosterone ◽

Phase Iii ◽

Adaptation Mechanism ◽

Upper Gastrointestinal

In our daily life, individuals encounter with various types of stress. Accumulation of daily life stress (chronic stress) often causes gastrointestinal symptoms and functional gastrointestinal diseases. Although some can adapt toward chronic stress, the adaptation mechanism against chronic stress remains unknown. Although acute stress delays gastric emptying and alters upper gastrointestinal motility, effects of chronic stress on gastric motility still remain unclear. We investigated the effects of acute (single stress) and chronic (repeated stress for 5 consecutive days) stress on solid gastric emptying and interdigestive gastroduodenal contractions in rats. It is well established that acute restraint stress inhibits solid gastric emptying via central corticotropin-releasing factor (CRF). To investigate whether the sensitivity to CRF is altered following chronic stress, CRF was administered intracisternally. Ghrelin is involved in regulating gastric emptying and upper gastrointestinal motility in rodents. The changes in plasma active ghrelin levels and mRNA expression in the stomach were studied following chronic stress. To evaluate the effects of chronic stress on the hypothalamus-pituitary-adrenal (HPA) axis, plasma corticosterone levels were also measured. Delayed gastric emptying observed in acute stress was completely restored following chronic stress. Acute stress abolished gastric phase III-like contractions, without affecting duodenal phase III-like contractions in the interdigestive state. Impaired gastric phase III-like contractions were also restored following chronic stress. Plasma ghrelin levels and ghrelin mRNA expression were increased significantly after chronic stress. Intracisternal injection of CRF delayed gastric emptying and impaired gastric motility in rats who received chronic stress. Plasma corticosterone concentrations were no more elevated following chronic stress. The restored gastric emptying following chronic stress was antagonized by the administration of ghrelin receptor antagonists. The adaptation mechanism may involve upregulation of ghrelin expression and attenuation of the HPA axis. In contrast, the sensitivity to central CRF remained unaltered following chronic stress in rats.

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Electrogastrography in Delayed Gastric Emptying

Paediatrica Indonesiana ◽

10.14238/pi38.9-10.1998.181-92 ◽

2017 ◽

Vol 38 (9-10) ◽

pp. 181

Author(s):

Badriul Hegar ◽

Yvan Vandenplas

Keyword(s):

Gastric Emptying ◽

Gastric Motility ◽

Delayed Gastric Emptying ◽

Myoelectric Activity ◽

Gastric Emptying Rate ◽

Gastric Myoelectric Activity ◽

Enteric Nerves ◽

Gastric Muscle ◽

Abnormal Rate ◽

Smooth Muscle Contractions

Disorders of gastric motility are generally manifested by an abnormal rate of gastric emptying. The emptying process of the stomach is very complex, and knowledge is limited to the observation that gastric emptying rate is a highly variable phenomenon, and that delayed gastric emptying is frequently the case. The advances in the knowledge of the physiology of gastric muscle and enteric nerves, and the recognition of the patterns of organization of smooth muscle contractions gave a new input to the study of gastric motility. The gastric emptying can be monitored in various ways, such as manometry, scintigraphy, or electrogastrography (EGG). Recently, EGG has received more attention. There is correlation between the EGG signal obtained from body surface electrodes and signals obtained directly from electrodes locates in the gastric muscle (serosal records). Some studies showed an association between EGG-findings and gastric motility disorders, and indicate that EGG is a reliable, non-invasive, useful method to detect gastric myoelectric activity.

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Restraint stress augments postprandial gastric contractions but impairs antropyloric coordination in conscious rats

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00161.2005 ◽

2006 ◽

Vol 290 (3) ◽

pp. R616-R624 ◽

Cited By ~ 26

Author(s):

Yukiomi Nakade ◽

Daisuke Tsuchida ◽

Hiroyuki Fukuda ◽

Masahiro Iwa ◽

Theodore N. Pappas ◽

...

Keyword(s):

Gastric Emptying ◽

Gastric Motility ◽

Restraint Stress ◽

Delayed Gastric Emptying ◽

Corticotropin Releasing Factor ◽

Conscious Rats ◽

Cholinergic Pathway ◽

Intracisternal Injection ◽

Gastric Contractions

Central corticotropin-releasing factor (CRF) plays an important role in mediating restraint stress-induced delayed gastric emptying. However, it is unclear how restraint stress modulates gastric motility to delay gastric emptying. Inasmuch as solid gastric emptying is regulated via antropyloric coordination, we hypothesized that restraint stress impairs antropyloric coordination, resulting in delayed solid gastric emptying in conscious rats. Two strain gauge transducers were sutured onto the serosal surface of the antrum and pylorus, and postprandial gastric motility was monitored before, during, and after restraint stress. Antropyloric coordination, defined as a propagated single contraction from the antrum to the pylorus within 10 s, was followed by ≥20 s of quiescence. Restraint stress enhanced postprandial gastric motility in the antrum and pylorus to 140 ± 9% and 134 ± 9% of basal, respectively ( n = 6). The number of episodes of antropyloric coordination before restraint stress, 2.4 ± 0.4/10 min, was significantly reduced to 0.6 ± 0.3/10 min by restraint stress. Intracisternal injection of the CRF type 2 receptor antagonist astressin 2B (60 μg) or guanethidine partially restored restraint stress-induced impairment of antropyloric coordination (1.6 ± 0.3/10 min, n = 6). The restraint stress-induced augmentation of antral and pyloric contractions was increased by astressin 2B and guanethidine but abolished by atropine, hexamethonium, and vagotomy. Restraint stress enhanced postprandial gastric motility via a vagal cholinergic pathway. Restraint stress-induced delay of solid gastric emptying is due to impairment of antropyloric coordination. Restraint stress-induced impairment of antropyloric coordination might be mediated via a central CRF pathway.

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Decreased Gastric Motility in Type II Diabetic Patients

BioMed Research International ◽

10.1155/2014/894087 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Yi-Chun Chiu ◽

Ming-Chun Kuo ◽

Christopher K. Rayner ◽

Jung-Fu Chen ◽

Keng-Liang Wu ◽

...

Keyword(s):

Gastric Emptying ◽

Gastric Motility ◽

Delayed Gastric Emptying ◽

Abdominal Discomfort ◽

Diabetic Patients ◽

Type Ii ◽

Elisa Method ◽

Lower Serum ◽

Blood Samples ◽

Analogue Scales

Background. To differentiate gastric motility and sensation between type II diabetic patients and controls and explore different expressions of gastric motility peptides.Methods. Eleven type II diabetic patients and health volunteers of similar age and body mass index were invited. All underwent transabdominal ultrasound for gastric motility and visual analogue scales. Blood samples were taken for glucose and plasma peptides (ghrelin, motilin, and glucacon-like peptides-1) by ELISA method.Results. Gastric emptying was significantly slower in diabetic patients than controls (T50: 46.3 (28.0–52.3) min versus 20.8 (9.6–22.8) min,P≤0.05) and less antral contractions in type II diabetic patients were observed(P=0.02). Fundus dimensions did not differ. There were a trend for less changes in gastrointestinal sensations in type II diabetic patients especially abdomen fullness, hunger, and abdominal discomfort. Although the serum peptides between the two groups were similar a trend for less serum GLP-1in type II diabetic patients was observed(P=0.098).Conclusion. Type II diabetic patients have delayed gastric emptying and less antral contractions than controls. The observation that there were lower serum GLP-1 in type II diabetic patients could offer a clue to suggest that delayed gastric emptying in diabetic patients is not mainly influenced by GLP-1.

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Dual effects of acupuncture on gastric motility in conscious rats

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00715.2002 ◽

2003 ◽

Vol 285 (4) ◽

pp. R862-R872 ◽

Cited By ~ 77

Author(s):

Makoto Tatewaki ◽

Mary Harris ◽

Kenichiro Uemura ◽

Tomio Ueno ◽

Etsuo Hoshino ◽

...

Keyword(s):

Gastric Motility ◽

Type A ◽

Peak Amplitude ◽

Phase Iii ◽

Type B ◽

Inhibitory Effects ◽

Complex Type ◽

Motility Index ◽

Conscious Rats ◽

Strain Gauge Transducer

The effects of manual acupuncture on gastric motility were investigated in 35 conscious rats implanted with a strain gauge transducer. Twenty (57.1%) rats showed no cyclic groupings of strong contractions ( type A), whereas 15 (42.9%) rats showed the phase III-like contractions of the migrating motor complex ( type B) in the fasting gastric motility. Acupuncture at the stomach (ST)-36 (Zusanli), but not on the back [Weishu, bladder (BL)-21], increased the peak amplitude of contractions to 172.4 ± 25.6% of basal in the type A rats ( n = 20, P < 0.05). On the other hand, the motility index for 60 min after the acupuncture was not affected by the acupuncture in this group. On the contrary, acupuncture decreased the peak amplitude and motility index to 72.9 ± 14.0% and 73.6 ± 16.2% in the type B rats ( n = 15, P < 0.05), respectively. The stimulatory and inhibitory effects of acupuncture observed in each type were reproducible on the separate days. In 70% of type A rats, acupuncture induced strong phase III-like contractions lasting for over 3 h that were abolished by atropine, hexamethonium, atropine methyl bromide, and vagotomy. Naloxone significantly shortened the duration of the stimulatory effects from 3.52 ± 0.21 to 1.02 ± 0.15 h ( n = 3, P < 0.05). These results suggest that acupuncture at ST-36 induces dual effects, either stimulatory or inhibitory, on gastric motility. The stimulatory effects are mediated in part via vagal efferent and opioid pathways.

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Gastric myoelectric and motor activity in dogs with gastric dilatation-volvulus

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1993.265.4.g646 ◽

1993 ◽

Vol 265 (4) ◽

pp. G646-G653

Author(s):

J. A. Hall ◽

T. N. Solie ◽

H. B. Seim ◽

D. C. Twedt

Keyword(s):

Wave Propagation ◽

Gastric Emptying ◽

Slow Wave ◽

Propagation Velocity ◽

Delayed Gastric Emptying ◽

Solid Phase ◽

Phase Iii ◽

Gastric Dilatation ◽

Wave Propagation Velocity ◽

Gastric Slow Wave

Electrical and contractile properties of the stomach were assessed in six adult dogs after recovery from surgical treatment for gastric dilatation-volvulus (GDV), a disorder characterized by delayed gastric emptying of the solid phase. Electrodes and strain-gauge force transducers were sutured to the serosa of the antrum and pylorus at the time of surgical intervention for GDV. Ten days after implantation, electrical and mechanical activities were recorded before and after a standardized meal. The analog FM tape recordings of the electrical and mechanical signals were converted to digital time series for analysis by computer. Recordings from dogs after GDV showed increased slow wave propagation velocity in both the fasting and the fed states compared with controls. In addition, the GDV dogs had atypical fasting state phase III activity fronts. We found no difference in gastric slow wave frequency, dysrhythmia, or electromechanical coupling between the two groups. These results indicate that delayed gastric emptying in this syndrome is associated with increased gastric slow wave propagation velocity.

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Intrinsic corporoantropyloric coordination of motility and gastric emptying

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1994.266.2.g255 ◽

1994 ◽

Vol 266 (2) ◽

pp. G255-G262 ◽

Cited By ~ 1

Author(s):

G. E. Holle ◽

E. Steinbach ◽

W. Forth

Keyword(s):

Gastric Emptying ◽

Slow Wave ◽

Gastric Motility ◽

Wave Amplitude ◽

Proximal Part ◽

Platinum Electrodes ◽

Motility Index ◽

X Ray ◽

Force Transducers ◽

Meat Meal

This study examined changes in gastric motility after interruption of the intramural nervous circuitry from the proximal portion of the stomach to the antrum by a circumferential gastric myotomy. Seven extraluminal strain gauge force transducers and five platinum electrodes were implanted along the antropyloroduodenal region, and gastric emptying was studied by X-ray after a 280-g solid meat meal mixed with barium. The motility index increased aboral to the myotomy by 106 and 69% in the distal antrum and pylorus, respectively, in the first postprandial 30-60 min because of the loss of an inhibitory neural influence from the proximal part of the stomach. Destabilization of the basic electrical rhythm occurred in 50% of the dogs. This was apparent as tachyarrhythmia or bradyarrhythmia and an early postprandial 2-11% decrease in slow-wave frequency and a 100% increase in slow-wave amplitude. Coordination of corporoantropyloric contractions was disorganized. Frequent segmenting and antidromic contractions were associated with reduced periods of optimal emptying and disturbed intragastric chyme transport into the constricted antrum. A 10-30% gastric emptying delay of approximately 50 min was a consequence of myotomy despite an increased antroduodenal motor gradient after myotomy. The overall results suggest that intact intramural innervation and muscular continuity are essential for coordination of corporoantropyloric motility and normal gastric emptying.

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