Pressure-geometry relationship in the antroduodenal region in humans

2001 ◽  
Vol 281 (5) ◽  
pp. G1214-G1220 ◽  
Author(s):  
Henryk Faas ◽  
Geoffrey S. Hebbard ◽  
Christine Feinle ◽  
Patrik Kunz ◽  
James G. Brasseur ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Glucose Solution ◽  
Contractile Activity ◽  
Propagation Speed ◽  
Intragastric Administration ◽  
Control Mechanisms ◽  
Resonance Imaging ◽  
High Resolution Manometry ◽  
Gastric Motor Function ◽  
Nutrient Infusion

Understanding of the control mechanisms underlying gastric motor function is still limited. The aim of the present study was to evaluate antral pressure-geometry relationships during gastric emptying slowed by intraduodenal nutrient infusion and enhanced by erythromycin. In seven healthy subjects, antral contractile activity was assessed by combined dynamic magnetic resonance imaging and antroduodenal high-resolution manometry. After intragastric administration of a 20% glucose solution (750 ml), gastric motility and emptying were recorded during intraduodenal nutrient infusion alone and, subsequently, combined with intravenous erythromycin. Before erythromycin, contraction waves were antegrade (propagation speed: 2.7 ± 1.7 mm/s; lumen occlusion: 47 ± 14%). Eighty-two percent (51/62) of contraction waves were detected manometrically. Fifty-four percent of contractile events (254/473) were associated with a detectable pressure event. Pressure and the degree of lumen occlusion were only weakly correlated ( r 2 = 0.02; P = 0.026). After erythromycin, episodes of strong antroduodenal contractions were observed. In conclusion, antral contractions alone do not reliably predict gastric emptying. Erythromycin induces strong antroduodenal contractions not necessarily associated with fast emptying. Finally, manometry reliably detects ∼80% of contraction waves, but conclusions from manometry regarding actual contractile activity must be made with care.

Modulation of gastric motor activity by a centrally acting stimulus, circular vection, in humans

2001 ◽  
Vol 280 (5) ◽  
pp. G850-G857 ◽  
Author(s):  
Henryk Faas ◽  
Christine Feinle ◽  
Paul Enck ◽  
David Grundy ◽  
Peter Boesiger
Keyword(s):  
Gastric Emptying ◽  
Healthy Subjects ◽  
Time Course ◽  
Delayed Gastric Emptying ◽  
Contractile Activity ◽  
Subjective Symptom ◽  
Gastric Volume ◽  
Rapid Decrease ◽  
Resonance Imaging ◽  
Baseline Activity

The aims of this study were to investigate gastric motor correlates of vection, a centrally acting stimulus, and relate these responses to the induction of motion sickness symptoms. Antral contractile activity and gastric volume retained after a liquid nutrient meal (600 ml) were assessed by magnetic resonance imaging in healthy subjects during two different protocols. Vection was induced by an optokinetic drum, and subjects repeatedly rated the intensity of vection and nausea on 0–10 analog scales. Vection delayed gastric emptying {99% (89–102%) [median (interquartile ranges)] of volume retained at 28 min; control situation: 79% (69–81%), P < 0.05}. Antral contractile activity followed a distinct time course of rapid decrease [−64% (−72 to −59%) change from baseline activity] immediately after onset of drum rotation followed by gradual recovery upon withdrawal of the stimulus. No relationship was found between the severity of nausea and inhibition of gastric emptying or antral contractile activity. The inhibition of antral contractile activity appears to be a good measure of the peripheral response to vection but is probably independent of subjective symptom induction.

scholarly journals Role of cholecystokinin in the regulation of liquid gastric emptying and gastric motility in humans: studies with the CCK antagonist loxiglumide

Gut ◽  
1997 ◽  
Vol 41 (4) ◽  
pp. 500-504 ◽  
Author(s):  
W Schwizer ◽  
J Borovicka ◽  
P Kunz ◽  
R Fraser ◽  
C Kreiss ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Gastric Emptying ◽  
Contractile Activity ◽  
Resonance Imaging ◽  
Proximal Stomach ◽  
Coronal Image ◽  
Distal Stomach ◽  
Antral Motility ◽  
Cck Antagonist

Background—Exogenous cholecystokinin (CCK) inhibits antral motility and slows gastric emptying (GE) but the effect of endogenous CCK on the gastric motor mechanisms responsible for GE remains unclear.Methods—The effect of the CCK-A antagonist loxiglumide (LOX) on GE and motility was studied using magnetic resonance imaging in six healthy volunteers after ingestion of 500 ml Intralipid 10% (550 kcal). Subjects were studied in the supine position on two occasions during intravenous infusion of LOX (66 μmol/kg/h for 10 min followed by 22 μmol/kg/h) or placebo. GE was determined every 15 minutes using transaxial abdominal scans and motility was studied by means of 120 coronal scans, 1.2 seconds apart. For each coronal image the proximal and distal (antral) diameters were measured at a fixed point in the stomach to determine contraction frequency (ACF) and amplitude (AMP).Results—GE was faster during LOX infusion than placebo (t1/2 31 (22) versus 115 (67) minutes, p<0.03). There was little variation in the diameter of the proximal stomach with either LOX or placebo. In the distal stomach marked contractile activity was observed during LOX (ACF 2.9 (0.2) versus 1.5 (2.9) during placebo, p<0.01). AMP also increased during LOX compared with placebo (56 (22)% versus 27 (16)%, p<0.001).Conclusion—The increases in antral motility are likely to contribute to the acceleration of GE and suggest that CCK may regulate GE by acting on the distal stomach although an effect on the proximal stomach cannot be excluded.

scholarly journals Effects of intragastric administration of L-tryptophan on the glycaemic response to a nutrient drink in men with type 2 diabetes — impacts on gastric emptying, glucoregulatory hormones and glucose absorption

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maryam Hajishafiee ◽  
Rachel A. Elovaris ◽  
Karen L. Jones ◽  
Leonie K. Heilbronn ◽  
Michael Horowitz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Emptying ◽  
Plasma Glucose ◽  
Glucose Absorption ◽  
Intragastric Administration ◽  
Glycaemic Response ◽  
C Peptide ◽  
Postprandial Glycaemia ◽  
Glucoregulatory Hormones

Abstract Background The rate of gastric emptying and glucoregulatory hormones are key determinants of postprandial glycaemia. Intragastric administration of L-tryptophan slows gastric emptying and reduces the glycaemic response to a nutrient drink in lean individuals and those with obesity. We investigated whether tryptophan decreases postprandial glycaemia and slows gastric emptying in type 2 diabetes (T2D). Methods Twelve men with T2D (age: 63 ± 2 years, HbA1c: 49.7 ± 2.5 mmol/mol, BMI: 30 ± 1 kg/m2) received, on three separate occasions, 3 g (‘Trp-3’) or 1.5 g (‘Trp-1.5’) tryptophan, or control (0.9% saline), intragastrically, in randomised, double-blind fashion, 30 min before a mixed-nutrient drink (500 kcal, 74 g carbohydrates), containing 3 g 3-O-methyl-D-glucose (3-OMG) to assess glucose absorption. Venous blood samples were obtained at baseline, after tryptophan, and for 2 h post-drink for measurements of plasma glucose, C-peptide, glucagon and 3-OMG. Gastric emptying of the drink was quantified using two-dimensional ultrasound. Results Tryptophan alone stimulated C-peptide (P = 0.002) and glucagon (P = 0.04), but did not affect fasting glucose. In response to the drink, Trp-3 lowered plasma glucose from t = 15–30 min and from t = 30–45 min compared with control and Trp-1.5, respectively (both P < 0.05), with no differences in peak glucose between treatments. Gastric emptying tended to be slower after Trp-3, but not Trp-1.5, than control (P = 0.06). Plasma C-peptide, glucagon and 3-OMG increased on all days, with no major differences between treatments. Conclusions In people with T2D, intragastric administration of 3 g tryptophan modestly slows gastric emptying, associated with a delayed rise, but not an overall lowering of, postprandial glucose.

Gastric emptying of glucose solution and associated plasma concentrations of GLP-1, GIP, and PYY before and after fundoplication

2007 ◽  
Vol 21 (2) ◽  
pp. 309-314 ◽  
Author(s):  
J. Miholic ◽  
M. Hoffmann ◽  
J.J. Holst ◽  
J. Lenglinger ◽  
M. Mittlböck ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Glucose Solution ◽  
Plasma Concentrations ◽  
Before And After

Relative contributions of “pressure pump” and “peristaltic pump” to gastric emptying

2000 ◽  
Vol 278 (4) ◽  
pp. G604-G616 ◽  
Author(s):  
K. Indireshkumar ◽  
James G. Brasseur ◽  
Henryk Faas ◽  
Geoffrey S. Hebbard ◽  
Patrik Kunz ◽  
...  
Keyword(s):  
High Pressure ◽  
Gastric Emptying ◽  
Muscle Tone ◽  
Contractile Activity ◽  
Average Rate ◽  
Gastric Volume ◽  
Peristaltic Pump ◽  
Pressure Pump ◽  
Significant Difference ◽  
Common Cavity

The relative contributions to gastric emptying from common cavity antroduodenal pressure difference (“pressure pump”) vs. propagating high-pressure waves in the distal antrum (“peristaltic pump”) were analyzed in humans by high-resolution manometry concurrently with time-resolved three-dimensional magnetic resonance imaging during intraduodenal nutrient infusion at 2 kcal/min. Gastric volume, space-time pressure, and contraction wave histories in the antropyloroduodenal region were measured in seven healthy subjects. The subjects fell into two distinct groups with an order of magnitude difference in levels of antral pressure activity. However, there was no significant difference in average rate of gastric emptying between the two groups. Antral pressure history was separated into “propagating high-pressure events” (HPE), “nonpropagating HPEs,” and “quiescent periods.” Quiescent periods dominated, and average pressure during quiescent periods remained unchanged with decreasing gastric volume, suggesting that common cavity pressure levels were maintained by increasing wall muscle tone with decreasing volume. When propagating HPEs moved to within 2–3 cm of the pylorus, pyloric resistance was found statistically to increase with decreasing distance between peristaltic waves and the pylorus. We conclude that transpyloric flow tends to be blocked when antral contraction waves are within a “zone of influence” proximal to the pylorus, suggesting physiological coordination between pyloric and antral contractile activity. We further conclude that gastric emptying of nutrient liquids is primarily through the “pressure pump” mechanism controlled by pyloric opening during periods of relative quiescence in antral contractile wave activity.

scholarly journals Effect of baclofen on liquid and solid gastric emptying in rats

2010 ◽  
Vol 47 (3) ◽  
pp. 290-296 ◽  
Author(s):  
Edgard Ferro Collares ◽  
Adriana Mendes Vinagre
Keyword(s):  
Gastric Emptying ◽  
Test Meal ◽  
Glucose Solution ◽  
Gastric Retention ◽  
Phenol Red ◽  
Gamma Aminobutyric Acid ◽  
Solid Meal ◽  
Inhibitory Neurotransmitter ◽  
Sterile Saline

CONTEXT: Gamma-aminobutyric acid (GABA) is a potent inhibitory neurotransmitter. There is evidence that GABA B receptors located in the dorsal complex and in afferent fibers of the vagus nerve participate in the control of gastrointestinal motility. OBJECTIVE: To assess the intracerebroventricularly (ICV) and intravenously (IV) effect of baclofen, a GABA B receptor agonist, on liquid and solid gastric emptying in rats. METHODS: Adult male Wistar rats weighing 250-300 g (n = 6-8 animals) were used. Gastric emptying of liquid test meals labeled with phenol red was evaluated by the determination of percent gastric retention (%GR) 10 and 15 min after orogastric administration of saline and 10% glucose meals, respectively. Baclofen was injected ICV (1 and 2 µg/animal) through a tube implanted into the lateral ventricle of the brain and was injected IV (1 and 2 mg/kg) into a tail vein. The gastric emptying of liquid was determined 10 or 30 min after ICV and IV baclofen administration, respectively. The gastric emptying of the solid meal was assessed by the determination of percent gastric retention 2 h after the beginning of the ingestion of the habitual ratio by the animal, consumed over a period of 30 min. Baclofen was administered ICV (1 and 2 µg/animal) or IV (1 and 2 mg/kg) immediately after the end of the ingestion of the solid meal. The control groups received vehicle (sterile saline solution) ICV or IV. RESULTS: The group of animals receiving baclofen ICV (2 mg/animal) presented a significantly lower (P<0.05, Tukey test) %GR (mean ± SEM) of the saline (18.1 ± 2.5%) compared to control (33.2 ± 2.2%). In the group receiving the drug IV, the gastric retention of the same test meal did not differ from control. ICV and IV administration of baclofen had no effect on the gastric emptying of the 10% glucose solution compared to control. ICV administration of 1 or 2 mg baclofen/animal significantly increased the gastric retention of the solid test meal (57.9 ± 6.5% and 66.6 ± 6.3%, respectively) compared to control (35.1 ± 4.4%). The same phenomenon was observed only with the IV dose of 2 mg/kg (71.9 ± 2.6%) compared to control (52.7 ± 2.8%). CONCLUSION: Baclofen administered: 1. ICV (2 µg/animal), but not IV, increased gastric emptying of a non-caloric isotonic liquid test meal (saline); 2. when administered ICV or IV, it had no effect of gastric emptying of a 10% glucose solution; 3) when administered ICV (1 and 2 mg/animal) and IV (2 mg/kg) it delayed the gastric emptying of the solid meal.

The control mechanisms of gastric emptying are not overridden by motor stimulants

1986 ◽  
Vol 251 (6) ◽  
pp. G744-G751 ◽  
Author(s):  
S. Wulschke ◽  
H. J. Ehrlein ◽  
C. Tsiamitas
Keyword(s):  
Gastric Emptying ◽  
Gastrointestinal Motility ◽  
Control Mechanisms ◽  
Wall Tension ◽  
Physiological Conditions ◽  
Duodenal Motility ◽  
Antral Motility

We wanted to determine if an acceleration of the normal emptying rate by motor stimulants interfers with control mechanisms limiting gastric emptying. Therefore, we studied the effects of 5-hydroxytryptophane (5-HTP) and cisapride on canine gastrointestinal motility and gastric emptying after ingestion of viscous acaloric and nutritive meals. Prolonged contractions and relaxations that change lumen size (isotonic component) and wall tension (isometric component) are defined as “basal contractions” and “basal relaxations”, respectively. The nutrient meal emptied much slower than the acaloric meal due to several alterations of gastric, pyloric, and duodenal motility. Both drugs stimulated antral motility but failed to accelerate gastric emptying of the nutrient meal. The main causes for the failure were a basal relaxation of the proximal antrum and a basal contraction of the duodenum. In conclusion, basal contractions of the proximal antrum and duodenum play an important role in the process of gastric emptying, and under physiological conditions the control mechanisms of gastric emptying provide an optimal emptying rate that cannot be markedly accelerated by 5-HTP and cisapride.

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