Dual effects of cisapride on gastric emptying and antropyloroduodenal motility

1993 ◽  
Vol 264 (2) ◽  
pp. G195-G201 ◽  
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.

scholarly journals Effect of gastric acid suppressants on human gastric motility

Gut ◽  
1998 ◽  
Vol 42 (2) ◽  
pp. 243-250 ◽  
Author(s):  
H P Parkman ◽  
J-L C Urbain ◽  
L C Knight ◽  
K L Brown ◽  
D M Trate ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Gastric Acid ◽  
Gastric Motility ◽  
Delayed Gastric Emptying ◽  
Normal Subjects ◽  
Phase Iii ◽  
Motility Index ◽  
Intravenous Saline ◽  
Antroduodenal Manometry ◽  
Therapeutic Doses

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.

scholarly journals Cholinergic effects on human gastric motility

Gut ◽  
1999 ◽  
Vol 45 (3) ◽  
pp. 346-354 ◽  
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.

Effects of nitroglycerin on liquid gastric emptying and antropyloroduodenal motility

1998 ◽  
Vol 275 (5) ◽  
pp. G1173-G1178 ◽  
Author(s):  
W.-M. Sun ◽  
S. Doran ◽  
K. L. Jones ◽  
E. Ooi ◽  
G. Boeckxstaens ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Gastric Emptying ◽  
Pressure Wave ◽  
Normal Subjects ◽  
Nitric Oxide Donor ◽  
Pressure Waves ◽  
The Subject ◽  
And Control ◽  
Male Subjects

The effects of the nitric oxide donor nitroglycerin on gastric emptying and antropyloroduodenal motility were evaluated in nine healthy male subjects (ages 19–36 yr). Antropyloroduodenal pressures were recorded with a manometric assembly that had nine side holes spanning the antrum and proximal duodenum and a pyloric sleeve sensor; gastric emptying was quantified scintigraphically. In each subject, the emptying of 300 ml of 25% glucose labeled with99mTc was assessed on two separate days during intravenous infusion of either nitroglycerin (5 μg/min in 5% dextrose) or 5% dextrose (control). Studies were performed with the subject in the supine position; blood pressure and heart rate were monitored. Nitroglycerin had no significant effect on blood pressure or heart rate. Nitroglycerin slowed gastric emptying ( P < 0.02), and this was associated with greater retention of the drink in the proximal stomach ( P < 0.05). In both nitroglycerin and control studies, ingestion of the drink was associated with an increase in the number of isolated pyloric pressure waves ( P < 0.05) and antral pressure wave sequences ( P < 0.05). Nitroglycerin reduced the number of isolated pyloric pressure waves ( P < 0.05), basal pyloric pressure ( P < 0.05), and the number of antral pressure wave sequences ( P < 0.05), but not the total number of antral pressure waves. The rate of gastric emptying and the number of isolated pyloric pressure waves were inversely related during control ( P = 0.03) and nitroglycerin ( P < 0.05) infusions. We conclude that in normal subjects, 1) gastric emptying of 300 ml of 25% glucose is inversely related to the frequency of phasic pyloric pressure waves, and 2) nitroglycerin in a dose of 5 μg/min inhibits pyloric motility, alters the organization but not the number of antral pressure waves, and slows gastric emptying and intragastric distribution of 25% glucose.

Sonographic comparison of gastric emptying of broth and water: is there a promoting cephalic factor?

2005 ◽  
Vol 46 (2) ◽  
pp. 132-134
Author(s):  
J. F. Pedersen
Keyword(s):  
Gastric Emptying ◽  
Vagus Nerve ◽  
Gastric Motility ◽  
Plain Water ◽  
Sham Feeding ◽  
Cephalic Phase ◽  
Gastric Emptying Time ◽  
The Mean ◽  
Antral Area ◽  
Stimulation Of

Purpose: To examine the emptying times of broth and water, and explore the possibility of a cephalic influence on gastric emptying. Material and Methods: On different days each of twelve healthy volunteers had meals of either 350 ml water or 350 ml broth. Subsequently ten volunteers had meals of water alone and of water followed by sham feeding with broth. The antral area was determined at sonography five times before the meal as a baseline, and every 1–4 minutes after the meal. The time until the antral area had decreased to 150% of baseline (T150) was determined and used as surrogate expression of gastric emptying time. Results: The mean T150 was for water 20.3 min (range 12–40), and was for broth significantly shorter 12.6 min (5–21), P = 0.0020. In the subsequent series the mean T150 was 28.5 min (18–49) for water, and significantly shorter for water followed by sham feeding, 22.8 (14–40), P = 0.0078. Conclusion: Broth empties faster from the stomach than plain water, probably because of a “cephalic phase” stimulation of gastric motility via the vagus nerve.

Changes in antroduodenal resistance induced by Cisapride in conscious dogs

1992 ◽  
Vol 263 (2) ◽  
pp. G202-G208
Author(s):  
C. H. Malbert ◽  
J. P. Serthelon ◽  
J. Dent
Keyword(s):  
Gastric Emptying ◽  
Stroke Volume ◽  
Conscious Dogs ◽  
Pressure Waves ◽  
Control Value ◽  
Stimulation Of

The effects of Cisapride on gastric outflow/pressure relationships have been examined in conscious dogs. In the digestive state, after inhibition of emptying in the first 10 min, Cisapride accelerated gastric emptying for 110 min by increasing the volume (7.3 +/- 1.2 vs. 2.3 +/- 0.3 ml) rather than by decreasing the interval between flow pulses (4.9 +/- 0.2 vs. 4.5 +/- 0.1s). After non-nutrient gastric loading, Cisapride also first inhibited and then accelerated gastric emptying as the consequence of both a larger stroke volume (8.0 +/- 1.7 vs. 3.2 +/- 0.5 ml) and more frequent pulses (3.9 +/- 0.1 vs. 4.9 +/- 0.1 s). In both situations, Cisapride increased the amplitude of the antral/pyloric pressure waves. Antropyloroduodenal resistance increased substantially in the first 10 min after Cisapride then recovered to its control value. We conclude that stimulation of antropyloroduodenal motility by Cisapride can both impede and increase gastric emptying by changes in antroduodenal resistance.

Naloxone and morphine inhibit gastric emptying of solids

1982 ◽  
Vol 60 (5) ◽  
pp. 732-734 ◽  
Author(s):  
M. C. Champion ◽  
S. N. Sullivan ◽  
M. Chamberlain ◽  
W. Vezina
Keyword(s):  
Gastric Emptying ◽  
Healthy Volunteers ◽  
Test Meal ◽  
Gastric Motility ◽  
Delayed Gastric Emptying ◽  
Opiate Receptors ◽  
Intravenous Morphine ◽  
Opiate Agonist ◽  
Control Study

Gastric emptying studies were performed on six healthy volunteers using a radioisotope test meal. Each subject was studied three times (control, morphine 7.5 mg, naloxone 2 mg). Both intravenous morphine and intravenous naloxone significantly delayed gastric emptying when compared with the control study. These results suggest that opiate receptors, opiate neurones, and enkephalin may regulate gastric motility and that under certain circumstances naloxone may act as an opiate agonist.

Duodenal intramural nerves in control of pyloric motility and gastric emptying

1992 ◽  
Vol 263 (1) ◽  
pp. G1-G5 ◽  
Author(s):  
P. J. Treacy ◽  
G. G. Jamieson ◽  
J. Dent ◽  
P. G. Devitt ◽  
R. Heddle
Keyword(s):  
Amino Acids ◽  
Fatty Acid ◽  
Gastric Emptying ◽  
Sham Operation ◽  
Pressure Waves ◽  
Intraduodenal Infusion ◽  
Supramaximal Stimulation ◽  
Pyloric Motility ◽  
Stimulation Of

We have investigated the role of ascending duodenal intramural nerves in the control of isolated pyloric pressure waves (IPPW) and liquid gastric emptying. In six pigs, the proximal duodenum was transected to interrupt intramural nerves. A further six pigs had a sham operation. Four weeks after operation, motility of the antrum, pylorus, and duodenum was recorded by side holes and a sleeve sensor. Gastric emptying of a 1,000-ml test meal was significantly more rapid in duodenum-transected animals (P less than 0.0001) during intraduodenal infusion of each of isosmolar dextrose (424 ml emptied), fatty acid (335 ml), and amino acids (396 ml) than in duodenum-intact animals (dextrose: 128 ml; fatty acid: 57 ml; amino acids: 192 ml). Associated with this, in duodenum-transected animals infusion of each of isosmolar dextrose, fatty acid, amino acids, and hyperosmolar saline failed to produce the stimulation of IPPW seen in duodenum-intact animals. In both duodenum-intact and -transected animals, supramaximal stimulation by intraduodenal infusion of 25% dextrose slowed gastric emptying and stimulated IPPW. Ascending duodenal intramural nerves are a major physiological pathway for nutrient- and osmolar-stimulated feedback control of pyloric motility and gastric emptying.

EFFECTS OF INCREASING DOSES OF PYROGLUTAMYL-HISTIDYL-PROLINE AMIDE ON SERUM THYROTROPHIN LEVELS IN NORMAL SUBJECTS

1972 ◽  
Vol 70 (1) ◽  
pp. 196-208 ◽  
Author(s):  
Bengt Karlberg ◽  
Sven Almqvist
Keyword(s):  
Normal Saline ◽  
Standard Dose ◽  
Normal Subjects ◽  
Response Curves ◽  
Clinical Observations ◽  
Trh Stimulation ◽  
Stimulation Tests ◽  
Serial Measurements ◽  
Serum Tsh ◽  
Stimulation Of

ABSTRACT The effects of the administration of normal saline in four normal subjects and the single iv injections of synthetic pyroglutamyl-histidyl-proline amide (TRH) in doses of 6.25, 12.5, 25, 50, 100, 200 and 400 μg in 12 healthy subjects were evaluated by clinical observations and serial measurements from −10 to + 360 minutes of serum TSH, PBI, STH, cholesterol, glucose and insulin. Normal saline and TRH 6.25 μg iv did not change the serum TSH level. The minimum iv dose of TRH increasing serum TSH within 10 minutes was 12.5 μg. Nine of 12 subjects gave maximal increases of serum TSH after TRH 100 μg and all after 200 and 400 μg. The time for the peak response varied with the dose from 15 to 60 minutes. The dose-response curves, average and individual, were complex and not linear. This was interpreted as a varying degree of stimulation of both pituitary synthesis and release of TSH by TRH. PBI changes were measured at 2 h and 6 h. Minimum dose for a significant increase of PBI was 12.5 μg and 6.25 μg of TRH for the respective times. No change in basal STH-levels occurred in 53 of 65 TRH-stimulation tests. Nine of the 12 changes in serum STH occurred in four subjects with varying basal STH-levels. No changes were found in serum cholesterol, glucose or insulin. Our results show that 50 μg of TRH can be used as a standard dose for the single iv stimulation of pituitary release of TSH. TRH stimulated both TSH and STH release in 18% of our tests.

scholarly journals Gastric Emptying of a Carbohydrate-electrolyte Solution in Healthy Volunteers Depends on Osmotically Active Particles

2013 ◽  
Vol 80 (5) ◽  
pp. 342-349 ◽  
Author(s):  
Chol Kim ◽  
Tadashi Okabe ◽  
Minoru Sakurai ◽  
Koji Kanaya ◽  
Keiichi Ishihara ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Healthy Volunteers ◽  
Electrolyte Solution ◽  
Active Particles

Comparison of the Renin Response to Dopamine and Noradrenaline in Normal Subjects and Patients with Autonomic Insufficiency

1974 ◽  
Vol 46 (4) ◽  
pp. 481-488 ◽  
Author(s):  
C. S. Wilcox ◽  
M. J. Aminoff ◽  
A. B. Kurtz ◽  
J. D. H. Slater
Keyword(s):  
Autonomic Failure ◽  
Sodium Intake ◽  
Plasma Renin ◽  
Normal Subjects ◽  
Control Groups ◽  
Autonomic Reflexes ◽  
Fractional Increase ◽  
The Mean ◽  
Autonomic Insufficiency ◽  
Stimulation Of

1. The effect on plasma renin activity (PRA) of dopamine and noradrenaline infusions was studied in three patients with Shy—Drager syndrome, three patients with Parkinson's disease and normal autonomic reflexes, and three healthy volunteers. The patients with the Shy—Drager syndrome had functional evidence of a peripheral lesion of the sympathetic nervous system and subnormal PRA on a controlled sodium intake. 2. In all subjects catecholamines were infused step-wise for 4 min until a 30% rise in systolic blood pressure occurred. 3. In each subject, PRA fell after noradrenaline but rose after dopamine. The mean fractional increase in PRA after dopamine was no less in the Shy—Drager patients than in the control groups. 4. The results suggest, first, that stimulation of dopamine receptors can release renin, and secondly, that inadequate renin stores cannot explain the low PRA found in our patients with autonomic failure.

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