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W F Keeling

Publications and source records attributed to W F Keeling.

5 recordsLinked to original sources

Loperamide abolishes exercise-induced orocecal liquid transit acceleration.

Previous work in our laboratory has found that mild physical activity accelerates mouth-to-large intestinal transit of lactulose in a mixed liquid meal. Because loperamide is commonly used as an antidiarrheal agent, we wondered if it would blunt the orocecal transit acceleration provoked by mild exercise. We investigated this equation in 12 healthy persons by comparing orocolonic liquid transit at rest and in mild exercise. Each subject ingested 8 mg loperamide 1 hr prior to study under both resting and exercise conditions. With loperamide treatment, exercise (walking at 5.6 km/hr) failed to hasten increased H2 excretion (mean transit time 72 +/- 12 min at rest, 90 +/- 15 min in exercise; P = NS). This result contrasts sharply with previously reported controls: loperamide completely abolished exercise-induced orocecal transit acceleration (-23 +/- 5 min in controls; +18 +/- 13 min with loperamide; P < 0.05). Compared with these same controls, resting transit was not significantly slowed by the drug, while transit in exercise was retarded (64 +/- 5 min in controls, 90 +/- 15 min with loperamide; P = 0.06). Loperamide left unchanged the heart rate and oxygen uptake rises associated with exercise. In summary, by showing that loperamide blocks an exercise effect on the upper gut, these results suggest that the drug might prove effective in treating some gut symptoms induced by physical activity.

Adult↗

Identical orocecal transit time and serum motilin in hyperthermia and normothermia.

Fever, exercise, and exposure to a hot environment can all cause symptoms of gastrointestinal dysfunction as they elevate body temperature. Nonetheless, the link between hyperthermia per se and these symptoms is unknown. To test the functional significance of increased body temperature, we investigated the influence of substantial passive hyperthermia on orocecal transit in 12 young, healthy men. Transit time was determined by a consistent rise in H2 concentration in a rebreathing apparatus after oral ingestion of 0.7 g lactulose/kg body weight. Lactulose was given in combination with a 350-ml liquid meal (360 kcal). After raising core temperature in warm water to 38.3 degrees C, orocecal transit time was identical to control (90 +/- 13 min at 38.3 degrees C, 92 +/- 13 min at 37.1 degrees C). While hyperthermia did elevate heart rate and minute ventilation, serum motilin, gastrin, and cortisol were similar in the two conditions. The failure of a passive core temperature rise to alter mouth-to-cecum transit suggests that this aspect of alimentary function is independent of body temperature.

Adult↗

Orocecal transit during mild exercise in women.

Little is known of the influence of exercise on movement of ingested food through the alimentary tract or of the association of several gastrointestinal hormones with transit rate in exercise. In this study, orocecal transit during mild exercise was measured in 21 women by detecting a rise in expired H2 after ingestion of 20 g lactulose in a 350-ml (360 kcal) liquid meal. Motilin, gastrin, and cortisol were measured in peripheral venous blood when, as evidenced by a breath H2 rise, the first portion of the meal arrived at the cecum. Comparison was made between seated rest and a treadmill walk at 5.6 km/h up a 2% grade. The walk predictably elevated heart rate, O2 uptake, and rectal temperature and also reduced transit time from 98 min at rest to 75 min during exercise (P less than 0.001). Faster transit in exercise was associated with a significant rise in cortisol, while gastrin and motilin levels were both unchanged. In conclusion, in women mild concurrent exercise accelerates orocecal transit rate of at least the first portion of nonabsorbable carbohydrate in a liquid meal. Although the mechanism for the effect remains unknown, it may be secondary to some aspect of the stress response to physical activity.

Adult↗

Supine position and sleep loss each reduce prolonged maximal voluntary ventilation.

Because of the prevalence of supine posture and sleep deprivation in both health and disease, we wondered how each of them influences prolonged maximal voluntary ventilation (MVV). Accordingly, we compared 12-second, 1-min, and 10-min isocapnic MVV supine with that measured in the upright posture in 8 healthy subjects. MVV decreased 6-10% supine, independent of test duration (p less than 0.01). Although end-expiratory lung volume was 0.47 liter lower during supine resting breathing (p less than 0.001), end-expiratory lung volumes during short-term MVV maneuvers were identical. To investigate any additional effect on MVV due to sleep loss, 12 healthy subjects performed 12-second, 1-min, and 30-min isocapnic MVV maneuvers in the supine position, either after normal sleep or after a 24-hour sleepless period. Sleep deprivation reduced MVV by 7-14%, again independent of test duration (p less than 0.05). Sleep loss also reduced the ventilation chosen to represent a submaximal (75%) breathing effect (p = 0.05), and it increased subjective ratings of fatigue and confusion (p less than 0.01). We conclude that supination and sleep deprivation together decrease both short- and long-term MVV by nearly 20%, with impairment of supination not caused by lung volume changes, and with the sleep loss effect occurring in tandem with a rise in the subjective assessment of breathing effort.

Adult↗

Gastrointestinal transit during mild exercise.

Although exercise is often recommended as therapy for constipation, almost nothing is known of the effects of exercise on rates of movement of material in the gastrointestinal tract. In this study we investigated the influence of mild exercise on transit of a liquid meal from the mouth to the large intestine. Orocecal transit time was determined by a consistent elevation of H2 concentration in a rebreathing apparatus after ingestion of 30 g lactulose; the lactulose was part of a 360-kcal, 350-ml liquid meal. Comparison of transit time was made, in 12 young healthy subjects, between seated rest and a treadmill walk at 5.6 km/h up a 2% grade. The walk elevated heart rate from 64 +/- 4 to 109 +/- 5 beats/min, O2 uptake (VO2) from 0.29 +/- 0.02 to 1.20 +/- 0.07 l/min STPD, and final rectal temperature from 37.0 +/- 0.1 to 38.3 +/- 0.1 degrees C (all P less than 0.01). Exercise speeded transit of the liquid meal, with mean rises in H2 concentration taking place 66 +/- 10 min after ingestion at rest, compared with 44 +/- 6 min after food intake during exercise (P less than 0.02). H2 concentrations in the rebreathing apparatus showed similar base lines in the two experiments, and quantitative increases in H2 concentration, although shifted in time by exercise, were otherwise identical. Subjects with the slowest resting transit rates showed the largest exercise effects (r = 0.79, P less than 0.05). These results indicate that mouth-to-cecum transit of at least the first portion of a liquid meal-based nonabsorbable carbohydrate marker is significantly accelerated during mild exercise.

Adult↗