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At least 181 records · Page 10Linked to original sources
PubMed2005

Regional differences in gastrointestinal motility disturbances during acute necrotising pancreatitis.

Patients with acute pancreatitis often suffer from intestinal motility disturbances but the mechanism of this dysfunction is largely unknown. We studied the effect of acute necrotising pancreatitis (ANP) on in vivo gastrointestinal motility and in vitro intestinal contractility in mice. ANP was induced non-invasively by feeding young female mice a choline-deficient ethionine-supplemented (CDE) diet during 72 h. Gastric emptying and intestinal transit were measured in vivo 15 min after intragastric gavage of a semiliquid Evans blue bolus. Gastric and intestinal neuromuscular function was determined in vitro on isolated muscle strips. ANP significantly decreased gastric emptying from 61.2 +/- 9.8 to 34.9 +/- 7.1% and intestinal transit from 63.4 +/- 5.6 to 32.5 +/- 5.4%. ANP did not affect receptor-dependent and receptor-independent gastric muscle contractions except the contractions to substance P, which were slightly inhibited. In intestinal muscle strips, ANP significantly decreased contractions to EFS, carbachol, PGF(2alpha), substance P and KCl. Our results show that ANP delays gastric emptying in vivo, associated with a specific reduction in substance P contractility in vitro. ANP also impairs intestinal transit in vivo, associated with a non-specific reduction of intestinal contractility in vitro. We conclude that ANP impairs gastrointestinal motility in mice with underlying regional differences in the pathogenic mechanisms.

Acute Disease↗
PubMed2006

Recent developments in gastrointestinal motility.

In the past decade, the results of many studies on gastrointestinal motility and perception have been published that may be relevant to the clinician. A new classification of oesophageal motor disorders has been proposed in which "ineffective oesophageal motility" largely replaces the former "non-specific oesophageal motor disorders". Recent studies have shown that the incidence of transient lower oesophageal sphincter relaxations can be reduced pharmacologically, and this may open doors to a new therapeutic approach in gastro-oesophageal reflux disease. The mechanisms through which hiatus hernia promotes reflux have become clearer. The recently developed technique of intraluminal impedance monitoring has made it possible to study oesophageal transit, non-acid reflux and its role in the generation of reflux symptoms, as well as the characteristics of belching. Measurement of gastric emptying by means of a non-radioactive isotope and breath-testing has become widely available but, unfortunately, this development has not yet been accompanied by the advent of new therapeutic options for gastroparesis. The term "enteric dysmotility" has been coined for the condition in which upper abdominal symptoms are associated with distinct small intestinal bowel motility disorders in the absence of ileus-like episodes. The role of high-amplitude propagated contractions in the pathogenesis of constipation has been further defined. In cases of suspected sphincter of Oddi dysfunction, manometry of both sphincters (IBD and pancreatic) is now felt to be advisable.

Constipation↗
PubMedDate not supplied

Gastrointestinal motility considerations in patients with short-bowel syndrome.

Short-bowel syndrome results from large resections of the small intestine that result in the malabsorption of nutrients and fluids. Following intestinal resection both morphological and functional adaptations of the residual intestine occur. While we have witnessed progress in the understanding of morphological adaptation, little is known about the effects of gastrointestinal motility in short-bowel syndrome. This article reviews what is currently known about gastrointestinal motility in the context of short-bowel syndrome and the motility considerations that impact on clinical management.

Biliary Tract↗
PubMed2006

In vitro and in vivo effects of ferulic acid on gastrointestinal motility: inhibition of cisplatin-induced delay in gastric emptying in rats.

AIM: To study the effects of ferulic acid on gastrointestinal motility both in vitro and in vivo. METHODS: Ferulic acid induced concentration-dependent stimulation of the basal tone of isolated guinea pig ileum (2-20 micromol/L) and isolated rat fundus (0.05-0.4 mmol/L). RESULTS: Ferulic acid significantly accelerated the gastrointestinal transit and gastric emptying in rats in a dose-dependent manner (50-200 mg/kg, po). Cisplatin (2.5-20 mg/kg, ip) induced a dose-dependent delay in gastric emptying in rats. Pretreatment with ferulic acid dose-dependently, significantly reversed the cisplatin-induced delay in gastric emptying. CONCLUSION: The endogenous prostaglandins (PGs) are involved in mediating the stimulant effects of ferulic acid. This effect of dietary ferulic acid may help improve other accompanying gastrointestinal symptoms such as abdominal discomfort and also may protect against emesis induced by cytotoxic drugs.

Animals↗
PubMed1980

Neurohumoral control of gastrointestinal motility.

The progress of gastrointestinal physiology is presently dominated by the concept of neuroendocrine regulation and the control of motility is in keeping with this concept. Progress in biochemistry, immunocytochemistry and radioimmunoassay in the past few years has produced a whole new collection of peptide molecules extracted from the digestive tract. Two facts are evident from these new data: (i) many peptides in the gastrointestinal tract are present in both endocrine cells and nerve fibers, and (ii) many peptides are found in both the brain and the gastrointestinal tract. There is thus a large wave of interest in the so-called brain-gut axis and in the relations between brain and gut and between nerves and hormones. The motile system of the gastrointestinal tract is a complex whole having several organizational levels. The morphological, fixed structure is a "cable" network comprising smooth muscle and intrinsic and extrinsic nerves. Control feedback loops may be evidenced at all levels-muscular, intrinsic, ganglionic and central. Local concentrations of circulating (endocrine) or paracrine peptides may act as modulators of this basic pattern by contributing to the depolarization or the hyperpolarization of smooth muscle cell membranes. The mode of action of these peptides reveals at least two different kinds of receptor sites: one on the smooth muscle cells and the other on the axons or cell bodies of intramural excitatory or inhibitory neurons. In addition, central nervous system effects may centrally modulate the long pathway reflexes travelling in the main vagosympathetic trunks. It is no longer possible to separate completely the neural from the hormonal in studying motility control. The whole neuroendocrine control complex must be investigated.

Animals↗
PubMed2000

Effect of dopamine on gastrointestinal motility during critical illness.

OBJECTIVE: To document the action of dopamine on gastrointestinal motility in mechanically ventilated patients. DESIGN: Crossover, randomized, placebo-controlled study. SETTING: General intensive care unit (ICU) in a university hospital. PATIENTS: Twelve mechanically ventilated patients in a stable hemodynamic condition, with no contraindication to enteral feeding. INTERVENTIONS: Dopamine (4 microg/kg per minute) and placebo were infused over 8 h (4 h fasting, followed immediately by 4 h nasogastric feeding at 100 kcal per hour) on two consecutive days, in a random order. Pressure changes in the gastric antrum (four sites) and in the duodenum (two sites) were recorded by perfused catheter manometry. Each session started with the institution of dopamine or placebo infusion. MEASUREMENTS AND RESULTS: The migrating motor complex and its three successive phases were identified (phase I, period of quiescence; phase II, period of irregular contractile activity; phase III or activity front, period of high-frequency, regular contractions). Contractions and activity fronts at each site were quantified during fasting and feeding. The mean duration of the fasting migrating motor complex was determined in the duodenum, as well as the contribution of each phase (phases I, II, III) to the length of the complete cycle. The propagation characteristics of each activity front were assessed visually. The number of contractions was lower in the antrum (p = 0.024) and phase III motor activity higher in the duodenum [incidence of activity fronts (p = 0.008); number of phase III contractions (p = 0.009)] during dopamine infusion than with placebo. These modifications observed under dopamine were related to decreased antral contractions during fasting (p = 0.050), increased incidence of activity fronts during feeding (p = 0.031), and increased number of phase III contractions during fasting (p = 0.037). In both groups (placebo and dopamine) activity fronts rarely started in the antrum, and abnormally propagated activity fronts were found in the duodenum in some patients. CONCLUSIONS: Low-dose dopamine adversely affects gastroduodenal motility in mechanically ventilated critically ill patients.

Adult↗
PubMed1998

Mechanism of inhibitory effect of glucagon on gastrointestinal motility and cause of side effects of glucagon.

Glucagon is commonly used during gastrointestinal examinations for the temporary inhibition of gastroduodenal movements. Three preparations of glucagon are now clinically available: those prepared by extraction from the pancreas (GL-P), by chemical synthesis (GL-S), and by genetic recombination (GL-G). The aim of this study was examine the mechanism of the inhibitory effect of glucagon on gastrointestinal motility and the cause of its side effects by comparing three glucagon preparations. In four conscious dogs, gastrointestinal contractions were monitored by means of chronically implanted force transducers. Each glucagon preparation (GL-P [15 microg/kg], GL-S [5, 15, 45 microg/kg], GL-G [15 microg/kg]), scopolamine butylbromide (0.4 mg/ kg), or saline was administered intravenously 20 min after the termination of spontaneous phase III contractions, and blood samples were taken at 5- to 10-min intervals. Barium was administered into the stomach 10 min after the infusion of each drug. The arrival of a barium meal in the stomach immediately stimulated gastrointestinal contractions, and the barium meal was expelled into the duodenum and jejunum from the stomach. Intravenous injection of 15 microg GL-S first stimulated duodenal contractions that propagated to the jejunum, followed by strong inhibition of the barium-induced gastrointestinal contractions. This inhibitory effect of glucagon and the activity of the glucagon-induced duodenal contractions were dose-related. The inhibitory effects of GL-G and GL-S were stronger than that of GL-P. Blood glucose and plasma insulin concentrations were raised after intravenous injection of each glucagon preparation, but there was no difference among the three preparations and no dose relationship. The inhibitory effects of glucagon depend on the material purity and dose, and the inhibitory mechanism was independent of any effect on carbohydrate metabolism. Glucagon administration caused phase III-like contractions in the duodenum and jejunum, which may be responsible for the side effects of glucagon.

Analysis of Variance↗
PubMed1991

Computerised method for acquisition and display of gastrointestinal motility data.

A computerised system is developed for the acquisition and display of gastrointestinal motility data which utilises a purpose developed software program called 'PC-motil', running on an IBM compatible microcomputer. 'PC-motil' displays data during collection, writes data to disk file and compresses all data at the end of a study on to a single monitor screen for convenient overview. Any area of interest, in single or multiple channels, may be selected and expanded for detailed examination. This system is tested by the recording of gastric and jejunal motility patterns of 11 healthy volunteers in fasting and fed states. All antral and jejunal migrating motor complexes (MMCs) in fasting studies, as well as all fed motility patterns were recognisable in both 'compressed' and 'expanded' form. The reproduction of motility patterns by the computer based system was indistinguishable from that of a conventional analogue chart recorder. This computerised system provides a convenient and cost-effective means of acquisition, storage and display of motility data in digital form.

Adult↗
PubMed2000

Fifty landmark discoveries in gastroenterology during the past 50 years. A brief history of modern gastroenterology at the millennium: Part II. Gastrointestinal motility, nutrition, and diseases of the lower gastrointestinal tract, liver, and pancreas.

During the last half century, many outstanding discoveries have revolutionized the clinical practice and science of gastroenterology. Although the scientific results are widely disseminated, the discoverers have received inadequate recognition and the history of their discoveries is largely unstudied and unknown. At the millennium, a committee selected 50 landmark discoveries in gastroenterology during the past 50 years. A brief history of each landmark discovery is presented. Part I was presented in the previous issue of Gastroenterology Clinics of North America. Part II presents landmark discoveries in gastrointerintal (GI) motility, clinical trials, nutrition, and diseases of the lower GI tract, liver, biliary tree, and pancreas.

Endoscopy, Digestive System↗
PubMed1976

Novel telemetric system for extraluminal measurement of gastrointestinal motility.

A frequency-modulated, telemetric system with a transducer sensitive to variation in distance between two points was developed and used to measure in vivo small intestinal motor function in unanesthetized dogs. The construction of the system and one application of it to the study of gastrointestinal motility is described. Data were recorded after fasting, 1 h after feeding a standardized meat meal, and after intravenous injections of pentagastrin. A significant increase in motility was seen after pentagastrin injections and feeding as compared to the motility pattern seen in a fasting animal, and the telemetric system was proven adequate for in vivo measurement of motility of the gastrointestinal tract.

Animals↗
PubMedDate not supplied

[Gastrointestinal motility in the elderly].

The existence of specific, age-related changes in gastrointestinal motility with clinical significance is controversial. Beside the more infrequent primary motility disorders, secondary motility disturbances associated with collagen vascular diseases, endocrinopathies, and neuromuscular diseases are prominent in the older and often multimorbid patients. Especially in geriatric patients, motility associated symptoms are undesired side-effects of drug therapy. The pathophysiology, clinical syndromes, and therapeutic principles of motility disorders in the elderly are discussed. The major symptoms of esophageal dysfunction are dysphagia, chest pain, heartburn, and regurgitation. Oropharyngeal dysphagia, mostly caused by cerebrovascular accidents and other neurologic disorders, leads to disturbances in food intake, and is often complicated by broncho-pulmonary infections arising from recurrent aspiration of food or saliva. Gastrointestinal reflux disease and spastic motility disorders of the esophagus are regarded as possible causes of angina-like chest pain after exclusion of cardiac diseases. Motility disturbances of the stomach and small bowel are often related to systemic disease (i.e., diabetes mellitus, chronic intestinal pseudo-obstruction) of drug side-effects. Mental and physical decline, reduced fluid intake, and constipating drugs are the most relevant factors for idiopathic constipation in the elderly. Fecal incontinence means a great psychological strain for older patients and leads to social isolation.

Age Factors↗
PubMed1984

Short-term and long-term effects of ranitidine and oxmetidine on gastrointestinal motility in sheep.

Short-term and specific motor effects of ranitidine on gastrointestinal motility of conscious sheep were recorded. These effects were prevented by atropine, but tachyphylaxis was observed after a second injection. Short-term effects on motility were not obtained with oxmetidine. Long-term effects for both ranitidine and oxmetidine, at high doses, were reducing the frequency of reticular contractions and shortening the interval between MMCs in a similar manner.

Animals↗
PubMed1989

Computer-assisted method for the analysis of postprandial gastrointestinal motility in conscious dogs.

A fully automated system to quantify different parameters of gastrointestinal motility and gastroduodenal co-ordination in conscious dogs was designed and built around a personal technical computer (HP 9816). Online it performs sampling of contractions on four different sites of the digestive tract for two dogs simultaneously, data reduction, drift correction and storage of data on hard disk. Offline it performs baseline determination, peak detection, calculation of motility parameters such as amplitude and interval, plus co-ordination between gastric and duodenal motility and presentation of the results in both tabular and graphic form. To illustrate the possibilities and advantages of the computer analysis the early postprandial motor patterns for antrum, duodenum and jejunum were quantified during the first hour after administration of a small test meal.

Animals↗
PubMed1998

Gastrointestinal motility and gastric tube feeding in mechanically ventilated patients.

OBJECTIVE: To determine the fasted and fed gastrointestinal motility characteristics that are possibly responsible for gastric retention in mechanically ventilated patients. DESIGN: Prospective, case series. SETTING: Surgical intensive care unit of a university hospital. PATIENTS: Seven patients who required mechanical ventilation for thoracic or combined thoracic-neurologic injuries and nine healthy volunteers. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Antroduodenal manometry was performed during fasting and gastric feeding with a polymeric diet in patients during mechanical ventilation, weaning, and after detubation. Gastric retention volumes were determined during gastric tube feeding. Motility data were compared with recordings from nine healthy volunteers. During the fasting state, under sedation and morphine, the migrating motor complex in patients was significantly (p < .001) shortened: median 32.0 vs. 101.0 mins in healthy volunteers. During gastric tube feeding, the motility pattern did not convert to a normal postprandial pattern until morphine was discontinued. An interdigestive or mixed interdigestive-postprandial pattern was seen during gastric tube feeding in most patients during morphine administration. Most (94%) of the activity fronts during gastric feeding started in the duodenum. Gastric retention percentages during gastric tube feeding were negatively correlated (r2=.44; p < .01) with antral motor activity. CONCLUSIONS: These data suggest that morphine administration affects antroduodenal motility in mechanically ventilated patients. The gastrointestinal motor pattern involved in impaired gastric emptying in morphine-treated patients is characterized by antral hypomotility and persisting duodenal activity fronts during continuous intragastric feeding. The observed motility patterns suggest that early administration of enteral feeding might be more effective into the duodenum or jejunum than into the stomach of mechanically ventilated patients.

Adult↗
PubMed2006

Making a case for domperidone in the treatment of gastrointestinal motility disorders.

There are very few treatment options currently available for patients with gastrointestinal motility disorders, especially patients with gastroparesis. Domperidone, a peripheral dopamine receptor antagonist, has been successfully used for decades in the US and marketed in many countries for the treatment of gastroparesis. Its use, however, has recently become controversial owing to safety concerns, and it has never been approved for marketing by the FDA. During the 1990s, domperidone was available to US gastroenterologists under a compassionate-use program by Janssen Pharmaceutica, as the manufacturer worked towards, and fell short of, full US market approval. Medical studies, trials and case reports demonstrate the superior efficacy of domperidone when compared with placebo and other pharmaceutical therapies available. Data on the cardiac toxicity associated with oral use of domperidone fail to be convincing.

Domperidone↗