Role of cholecystokinin as a regulator of solid and liquid gastric emptying in humans

The role of endogenous cholecystokinin (CCK) in the regulation of gastric emptying remains controversial. We therefore studied the effect of the CCK-A receptor antagonist loxiglumide on gastric emptying of a high-caloric solid-liquid meal in humans. Gastric emptying was assessed in eight volunteers using intravenous loxiglumide or placebo in a randomized double-blind order. Subjects were studied by a dual-headed gamma camera after ingestion of a pancake (570 kcal) labeled with 99mTc-sulfur colloid and 500 ml 10% glucose containing 111In-diethylenetriamine pentaacetic acid. Plasma CCK was measured by a specific radioimmunoassay. Loxiglumide markedly accelerated gastric emptying of both phases of the meal. The lag period was shortened by 26% (P < 0.03); the area under the emptying curve and half-emptying time of solid emptying were lowered by 19 and 24% (P < 0.02) and of liquid emptying by 18 and 24% (P < 0.04), respectively. Plasma CCK levels were higher during infusion of loxiglumide compared with placebo (P < 0.02). These data demonstrate that post-prandially released CCK is a major regulator of gastric emptying of physiological meals containing both solid and liquid components.

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Comparison of methods for analyzing gastric isotope emptying

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1982.243.3.g237 ◽

1982 ◽

Vol 243 (3) ◽

pp. G237-G242 ◽

Cited By ~ 1

Author(s):

M. C. Dugas ◽

R. R. Schade ◽

D. Lhotsky ◽

D. Van Thiel

Keyword(s):

Gastric Emptying ◽

Transit Time ◽

Gamma Camera ◽

Statistical Difference ◽

Mean Transit Time ◽

Comparison Of Methods ◽

Sulfur Colloid ◽

The Mean ◽

Linear Regressions ◽

99Mtc Sulfur Colloid

The gastric emptying of 99mTc-sulfur colloid, ingested in a nutrient liquid test meal, was followed by gamma camera for normals, diabetics, and diabetics receiving intravenous metoclopramide. Gastric emptying patterns of 99mTc by these groups present as normal, slow, and rapid on simple graphic inspection. Half times of indicator emptying were computed from inspection and from least-squares linear regressions of log(base e) residue versus time for the total postpeak curve and for the remainder of the 15-min postpeak curve. In addition, the percent of 99mTc residue leaving at, and the area under, the residue curve until 6, 12, 24, and 60 min postpeak and the indicator mean transit time (MTT) were computed. Standard half-time determinations revealed no significant differences among the three groups, despite obvious visual differences among them. In contrast, the mean transit time of the rapid group was significantly less than that of the slow (P less than 0.01) and normal (P less than 0.05) groups. However, no statistical difference was noted between the slow and the normal emptiers (P greater than 0.1) using the MTT measure. The percent of particles leaving the stomach and the area under the residue curves demonstrated significant differences among the three groups, reflecting the obvious visual perceptions gained from simple curve inspection. Because the percent of indicator particles leaving the stomach region at a given time reflects a single time, it was concluded that the residue area represents the most reliable, objective, and quantifiable parameter for testing of significant differences.

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Relation between antral motility and gastric emptying of solids and liquids in humans

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1985.249.5.g580 ◽

1985 ◽

Vol 249 (5) ◽

pp. G580-G585 ◽

Cited By ~ 30

Author(s):

M. Camilleri ◽

J. R. Malagelada ◽

M. L. Brown ◽

G. Becker ◽

A. R. Zinsmeister

Keyword(s):

Gastric Emptying ◽

Liquid Phase ◽

Exponential Model ◽

Two Phase ◽

Motility Index ◽

Liquid Component ◽

Antral Motility ◽

Lag Period ◽

99Mtc Sulfur Colloid

Our aim was to test the hypothesis that there is a relation between antral phasic pressure activity and the emptying of solids and liquids from the intact human stomach after a mixed meal. This hypothesis was evaluated in 14 healthy individuals in whom we performed simultaneous antral manometry and radioscintigraphy after ingestion of a meal labeled with [99mTc]sulfur colloid in cooked egg (solid component) and [111In]DTPA (liquid component). Analysis of the data included an in-depth evaluation of different models for expressing both gastric emptying rates and antral pressure activity. We found that gastric emptying was adequately represented by a two-phase model consisting of lag and emptying periods and by a power exponential model for the liquid phase. Distal antral motility was accurately represented by the slope of the cumulative antral motility index. During the lag period for solids, the antral motility was inversely related to the duration of the lag. During the solid-emptying period, there was a positive correlation between emptying of solids and antral motility. No significant relation was found between antral motility and overall emptying of the liquid phase of the meal. However, a relationship was found when antral motility was related to liquid emptying after an initial lag period for solids. These human data are consistent with a role of antral pressure activity in trituration of solid food and a role of the antrum in the subsequent propulsion of solids and liquids from the stomach.

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Relation between postprandial gastric emptying and cutaneous electrogastrogram in primates

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1991.261.2.g248 ◽

1991 ◽

Vol 261 (2) ◽

pp. G248-G255 ◽

Cited By ~ 1

Author(s):

S. Bruley des Varannes ◽

M. Mizrahi ◽

A. Dubois

Keyword(s):

Gastric Emptying ◽

Rhesus Monkeys ◽

Motion Artifacts ◽

Motion Sensors ◽

Sulfur Colloid ◽

Postprandial Period ◽

Band Pass ◽

Two Parameters ◽

Solid Liquid ◽

99Mtc Sulfur Colloid

The relation between the cutaneous electrogastrogram (EGG) and gastric emptying was investigated in six rhesus monkeys. Gastric emptying was measured using scintigraphy after administration of two 80-ml mixed solid liquid meals (1.5 and 5.0 kcal/kg) tagged with 99mTc-sulfur colloid and 111In-diethylenetriamine pentaacetic acid. Six epigastric bipolar recordings of the EGG were concurrently obtained, digitized, and band-pass filtered. Portions of the signal with motion artifacts were automatically detected and excluded using two microwave motion sensors. During the early postprandial period, gastric emptying was greater after the 1.5-kcal/kg meal than after the 5-kcal/kg meal, and EGG amplitude increased significantly compared with fasting only after the 1.5-kcal/kg meal. Both emptying and EGG amplitude subsequently decreased after the 1.5-kcal/kg meal, whereas these two parameters increased after the 5-kcal/kg meal. As a result, EGG amplitude was significantly correlated with gastric emptying of solids in all six animals. In contrast, EGG frequency was not significantly different between the two meals and was not correlated with emptying. These results indicate that both the EGG and gastric emptying are modified differently by meals with different caloric contents and that the EGG may represent a useful, although indirect, index of gastric emptying.

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Effect of caloric content and composition of a liquid meal on gastric emptying in the rat

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1994.267.5.r1163 ◽

1994 ◽

Vol 267 (5) ◽

pp. R1163-R1167 ◽

Cited By ~ 3

Author(s):

L. L. Maerz ◽

H. Sankaran ◽

S. J. Scharpf ◽

C. W. Deveney

Keyword(s):

Gastric Emptying ◽

Gamma Camera ◽

Casein Hydrolysate ◽

Caloric Content ◽

Diethylenetriaminepentaacetic Acid ◽

Sprague Dawley ◽

Substrate Composition ◽

Liquid Meal ◽

Time Points ◽

Sprague Dawley Rats

We examined the effect of caloric content and substrate composition on gastric emptying in conscious Sprague-Dawley rats using gastric radioscintigraphy. Three-milliliter volumes of normal saline, glucose, casein hydrolysate, or intralipid containing 0, 1, 2, 3, or 6 kcal labeled with 99mTc-diethylenetriaminepentaacetic acid were given intragastrically. Gamma-camera imaging and computer analysis allowed construction of gastric emptying curves constructed over many time points for each emptying study. There was no difference in the half-emptying times (t1/2) between different substrates with equal calories, and increasing calories significantly prolonged gastric emptying for all substrates. Emptying occurred in a linear fashion with meals containing calories. With 3-ml meals containing 2, 3, or 6 kcal, the rate of delivery of calories to the duodenum is constant regardless of substrate or change in caloric content. We conclude that the rate of caloric delivery to the small intestine with gastric infusion of 1-6 kcal is relatively constant despite differences in total caloric load, substrate composition, and osmolarity.

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Parallel Gastric Emptying of Nonhydrolyzable Fat and Water After a Solid-Liquid Meal in Humans

Gastroenterology ◽

10.1016/s0016-5085(82)80249-7 ◽

1982 ◽

Vol 82 (5) ◽

pp. 877-881 ◽

Cited By ~ 32

Author(s):

Antoine Cortot ◽

Sidney F. Phillips ◽

Juan-R. Malagelada

Keyword(s):

Gastric Emptying ◽

Liquid Meal ◽

Solid Liquid

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S2089 Mechanism of Enhanced Satiety After a Soup Compared to Equicaloric Mixed Solid/Liquid Meal: Delayed Gastric Emptying, Enhanced Gallbladder Contraction and Small Bowel Content

Gastroenterology ◽

10.1016/s0016-5085(09)61504-3 ◽

2009 ◽

Vol 136 (5) ◽

pp. A-328

Author(s):

Luca Marciani ◽

Nicholas J. Hall ◽

Susan E. Pritchard ◽

John J. Totman ◽

Caroline L. Hoad ◽

...

Keyword(s):

Gastric Emptying ◽

Small Bowel ◽

Delayed Gastric Emptying ◽

Gallbladder Contraction ◽

Liquid Meal ◽

Bowel Content ◽

Solid Liquid

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Effect of dexfenfluramine on gastric emptying of a mixed solid-liquid meal in obese subjects

British Journal Of Nutrition ◽

10.1079/bjn19900132 ◽

1990 ◽

Vol 63 (3) ◽

pp. 447-455 ◽

Cited By ~ 5

Author(s):

Michael Horowitz ◽

Anne Maddox ◽

Judith Wishart ◽

Jane Vernon-Roberts ◽

Barry Chatterton ◽

...

Keyword(s):

Gastric Emptying ◽

Side Effects ◽

Obese Patients ◽

Solid Meal ◽

Liquid Meal ◽

Placebo Capsule ◽

Obese Subjects ◽

Treatment Of Obesity ◽

Solid Liquid ◽

Double Isotope

Recent studies suggest that dexfenfluramine (D-fenfluramine), because of its pure serotonergic effect, may be a more potent anti-obesity agent, associated with fewer side-effects than the racemate DL-fenfluramine. The effect of dexfenfluramine on gastric emptying of a mixed solid and liquid meal was assessed with a double-isotope scintigraphic technique in eleven obese patients. Each subject took a placebo capsule on the morning and evening of the day before, and on the morning of the first gastric emptying measurement. Dexfenfluramine was then taken at a dose of 15 mg twice daily and gastric emptying measurements were performed at 5 and at 29 d after the initiation of active treatment. Dexfenfluramine significantly slowed gastric emptying of the solid meal at both 5 and 29d when compared with the placebo (P < 0.05) and also delayed emptying of solid food from the proximal stomach (P < 0.01), but no significant effect on liquid emptying was observed. No significant side-effects were reported and there was a marginal weight loss (P< 0.005) during treatment. We conclude that inhibition of gastric emptying may contribute to the efficacy of dexfenfluramine in the treatment of obesity.

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Gastric emptying of a solid-liquid meal measured with 13C octanoic acid breath test (OBT) and real-time ultrasonography (RUS): A comparative study

Digestive and Liver Disease ◽

10.1016/s1590-8658(00)80814-2 ◽

2000 ◽

Vol 32 ◽

pp. A160

Author(s):

G. Cappello ◽

M.G. Malatesta ◽

A.F. Ciccaglione ◽

A. Ferri ◽

S. Toracchio ◽

...

Keyword(s):

Gastric Emptying ◽

Comparative Study ◽

Real Time ◽

Breath Test ◽

Octanoic Acid ◽

Liquid Meal ◽

Solid Liquid ◽

Real Time Ultrasonography

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Role of vagus nerve in postprandial antropyloric coordination in conscious dogs

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00195.2004 ◽

2005 ◽

Vol 288 (3) ◽

pp. G487-G495 ◽

Cited By ~ 28

Author(s):

Tomio Ueno ◽

Kenichiro Uemura ◽

Mary B. Harris ◽

Theodore N. Pappas ◽

Toku Takahashi

Keyword(s):

Gastric Emptying ◽

Vagus Nerve ◽

Late Phase ◽

Motor Pattern ◽

The Body ◽

Conscious Dogs ◽

Solid Meal ◽

Liquid Meal ◽

Vagal Blockade

It is generally believed that gastric emptying of solids is regulated by a coordinated motor pattern between the antrum and pylorus. We studied the role of the vagus nerve in mediating postprandial coordination between the antrum and pylorus. Force transducers were implanted on the serosal surface of the body, antrum, pylorus, and duodenum in seven dogs. Dogs were given either a solid or a liquid meal, and gastroduodenal motility was recorded over 10 h. Gastric emptying was evaluated with radiopaque markers mixed with a solid meal. Dogs were treated with hexamethonium, NG-nitro-l-arginine methyl ester (l-NAME), or transient vagal nerve blockade by cooling. A postprandial motility pattern showed three distinct phases: early, intermediate, and late. In the late phase, profound pyloric relaxations predominantly synchronized with giant antral contractions that were defined as postprandial antropyloric coordination. A gastric emptying study revealed that the time at which gastric contents entered into the duodenum occurred concomitantly with antropyloric coordination. Treatment by vagal blockade or hexamethonium significantly reduced postprandial antral contractions and pyloric relaxations of the late phase. l-NAME changed pyloric motor patterns from relaxation dominant to contraction dominant. Solid gastric emptying was significantly attenuated by treatment with hexamethonium, l-NAME, and vagal blockade. Postprandial antropyloric coordination was not seen after feeding a liquid meal. It is concluded that postprandial antropyloric coordination plays an important role to regulate gastric emptying of a solid food. Postprandial antropyloric coordination is regulated by the vagus nerve and nitrergic neurons in conscious dogs.

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