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At least 199 records · Page 11Linked to original sources
PubMed1993

Autonomic dysfunction in gastrointestinal motility disorders.

The records of 113 consecutive patients with a suspected gastrointestinal motility disorder referred between January 1988 and July 1991 were retrospectively reviewed. The aims were to identify the prevalence of autonomic dysfunction in those with or without associated neurological disease and to determine the diagnostic value of testing for autonomic dysfunction. All patients had gastrointestinal manometry (3 hours fasting, 2 hours fed), 94 of 113 underwent testing of sympathetic adrenergic and cholinergic function and cardiovagal cholinergic function. All tests were scored in a standard manner. There was a significant (p < 0.05) but modest (r = 0.28) rank correlation between autonomic and motility scores. This correlation was stronger (r = 0.67, p = 0.01) in diabetic patients. The number of patients in each group with autonomic dysfunction was as follows: irritable bowel syndrome nine of 33, idiopathic upper gastrointestinal dysmotility six of 21, diabetes mellitus nine of 13, identified non-diabetic neurological syndromes six of nine, postvagotomy or abdominal surgery three of 11, and myopathic pseudo-obstruction two of seven. Autonomic testing is useful in the assessment of autonomic involvement outside the gastrointestinal tract. Logistic discriminant analysis showed that autonomic function testing did not add to the diagnostic value of motility tests in distinguishing between patients with and without irritable bowel syndrome, although a slight improvement was indicated for identifying neuropathic dysmotilities. Thus, the aetiological role of general autonomic dysfunction in irritable bowel syndrome and idiopathic and postvagotomy dysmotilities deserves further study. The addition of autonomic function tests does not add substantially to the diagnostic accuracy of clinical, radiological, endoscopic, and manometric techniques in most patients referred for evaluation of a suspected motility disorder.

Autonomic Nervous System Diseases↗
PubMed1993

Effect of exogenous pancreatic enzymes on gastrointestinal and pancreatic hormone release and gastrointestinal motility.

In clinical practice, exogenous pancreatic enzymes are administered for the treatment of pancreatogenic steatorrhea or with the intention to relieve pain due to chronic pancreatitis. Moreover, a large number of patients take pancreatin (i.e., exogenous pancreatic enzymes) for functional dyspepsia. The effect of exogenous pancreatic enzymes on the enteropancreatic axis is a complex issue. Intraduodenal but not intrajejunal protease activity appears to exert a dose-dependent negative feedback on exocrine pancreatic secretion. Only enzymes with a proteolytic activity but not amylase and lipase exert a control on pancreatic secretion. The mechanism responsible for this feedback regulation is debated, but the cholinergic system seems to play a major role. Intraduodenal pancreatic enzymes (pancreatin) lead to an increased release of pancreatic polypeptide but do not affect the release of insulin and glucagon. In addition, pancreatic enzymes have an influence on the release of some gastrointestinal hormones (i.e., cholecystokinin, motilin, gastric inhibitory polypeptide). Neither exogenous nor endogenous pancreatic enzymes seem to play a major role in the regulation of interdigestive gastrointestinal motility. However, an adequate rate of postprandial pancreatic output is required to control gastric emptying. Current knowledge on the effect of exogenous pancreatic enzymes on the enteropancreatic axis, gut peptide release and gastrointestinal motility are updated in the present article.

Celiac Disease↗
PubMed2000

Effect of acute and chronic administration of L-arginine on morphine induced inhibition of gastrointestinal motility.

Effect of acute and chronic administration of L-arginine on morphine induced gastrointestinal inhibition was tested in rats. In the test for acute effect, L-arginine (200 mg/kg, i.v.) was given 10 minutes before the charcoal meal test. In the test for chronic effects, L-arginine (200 mg/kg, i.v.) was given twice a day for 4 days. Charcoal meal test was done on the fifth day. Morphine was administered 45 minutes before the charcoal meal test. Results showed that acute administration of L-arginine did not affect the morphine's action on the GIT. In contrast, chronic administration of L-arginine reversed the morphine induced decrease in gastrointestinal motility. The reversal was however, not complete. This data suggests that inhibition of NO may be one of the mechanism of morphine induced constipation.

Animals↗
PubMed1983

Effect of some new H2-receptor antagonists on gastrointestinal motility.

Some new histamine H2-receptor antagonists were tested for their effects on gastrointestinal motility. Ranitidine was found to possess definite stimulatory effects which appeared to be connected with an interference with the cholinergic system and occurred, though in different degree, from the lower esophageal sphincter (LES) to the colon. Etintidine, on the contrary, showed a remarkable antimuscarinic effect on the LES of the rat and the guinea-pig. Cimetidine, SK&F 93479 and tiotidine were virtually ineffective whereas oxmetidine exerted a consistent inhibitory activity on both basal motility and on the contractions induced by a variety of stimulatory agents. This effect, which was completely independent of the autonomic nervous system appeared to be connected with an inhibition of the transport of calcium ions. All the above results suggest that the H2-antagonists so far available may not be absolutely selective for the H2-receptor but may be endowed with non-specific effects which could have an interest at least from a pharmacological viewpoint.

Animals↗
PubMed1989

[Disorders of gastrointestinal motility--diabetes mellitus].

Diabetic motility disturbances are frequent and may be found within esophagus, stomach, small bowel, colon and anal sphincter. Disturbed motility may explain gastrointestinal symptoms of patients with diabetic enteropathy, but there is no correlation between symptoms and extent of motility changes. Prokinetic drugs relief symptoms, but also without improving motility parameters. Diarrhea is best treated by local opoid agonists (loperamide), in anorectal incontinence biofeedback training is also to be recommended.

Autonomic Nervous System↗
PubMed1987

Effects of afferent stimulation of the lingual nerve on gastrointestinal motility in the rat.

Effects of afferent stimulation of the lingual nerve (LNAS) on gastrointestinal motility and the reflex pathways which mediate the response to LNAS were investigated in rats. LNAS induced excitatory, inhibitory or biphasic responses in the stomach, duodenum and proximal colon. These responses continued after bilateral vagotomy, but were abolished after additional bilateral splanchnicotomy or transection of the spinal cord between Th4 and Th5. The inhibitory, excitatory and biphasic responses induced by LNAS were not affected by decerebration. Both after administration of atropine (0.2 mg/kg, i.v.) and guanethidine (3-5 mg/kg, i.v.), LNAS-induced excitatory and inhibitory responses were abolished in most cases, but the slight inhibitory response in the stomach and duodenum to LNAS remained in a few cases. These results suggest that the reflex centers which cause LNAS-induced excitatory and inhibitory responses are located in the dorsal nucleus of vagus and that the reflex pathways include the vagus and splanchnic nerves.

Afferent Pathways↗
PubMed2003

[Effect of different anesthesias on gastrointestinal motility after laparoscopic cholecystectomy].

OBJECTIVE: To compare the effect of three different anesthesias on gastrointestinal motility after laparoscopic cholecystectomy (LC). METHODS: Forty-two patients undergoing LC were randomly allocated to the combined epidural-general anesthesia group (Group A, n = 14), propofol-based total intravenous anesthesia group (Group B, n = 14) and isoflurane-based inhalational-intravenous general anesthesia group (Group G, n = 14). The concentration of plasma motilin was measured; the incidence of postoperative nausea and vomiting and the first flatus time were observed; and the in-hospital day was recorded. RESULTS: 1. The concentration of plasma motilin increased significantly during the first 1 h postoperatively (P < 0.05), but it had no significant difference in the 48 h after operation (P > 0.05) in comparison with the preoperative data in the three groups. The concentration of plasma motilin in Group C was much higher than that in the other two groups during the first 1 h postoperatively (P < 0.05). 2. The incidence of postoperative nausea and vomiting was much higher in Group C than that in the other two groups during the first 6 h postoperatively (P < 0.05), but there was no significant difference in the 6 h after operation in the three groups (P > 0.05). 3. The first flatus time and in-hospital day postoperatively had no statistical difference in the three groups (P > 0.05). CONCLUSION: Different anesthesias do not influence the recovery of intestinal motion and in-hospital day postoperatively; the combined epidural-general anesthesia and propofol-based total intravenous anesthesia may be ideal anesthesias because of the lower incidence of postoperative nausea and vomiting.

Adult↗
PubMed1991

Effects of parenteral diclofenac sodium on upper gastrointestinal motility after food in man.

In experimental animal models nonsteroidal anti-inflammatory drugs may influence gastrointestinal motility, but as evidence is lacking in man. The effect of diclofenac sodium 75 mg i.m. on the motor response of the upper gastrointestinal tract to food has been studied by manometry in 9 healthy volunteers. Diclofenac had no effect on the motor activity of the stomach, duodenum, or jejunum after a 605 kcal meal.

Adult↗
PubMed1979

Canine gastrointestinal motility effects of prostaglandin F2 alpha in vivo.

Prostaglandin F2 alpha (PGF2 alpha) has recently been implicated in the pathogenesis of some diarrhea in man. PGF2 alpha has been shown to increase the smooth muscle contractile motility of some gastrointestinal muscles in vitro. The in vivo effects of PGF2 alpha on bowel smooth muscles are not clearly delineated. The aim of this study was to investigate the effect of PGF2 alpha on motility of the small and large intestine in the anesthetized dog. Six contractile force transducers were implanted to record contractions from both the circular and longitudinal muscles of the duodenum, ileum and colon. Blood pressure was monitored from the femoral artery and drug injections were made in the femoral vein. The i.v. administration of PGF2 alpha (1 microgram/kg/min) significantly stimulated duodenal circular muscle contractile frequency while depressing the longitudinal muscle contractile tone. In the ileum, PGF2 alpha markedly stimulated circular and longitudinal muscle contractions. In the circular ileum, tone was significantly increased while in the longitudinal ileum it was significantly decreased. In the colon PGF2 alpha did not significantly affect intestinal motility. These results suggest that the diarrheal effects of PGF2 alpha may be related to an effect on small bowel rather than on large bowel motility in the dog.

Animals↗
PubMed1999

Effects of morphine and tramadol on somatic and visceral sensory function and gastrointestinal motility after abdominal surgery.

BACKGROUND: Chronic nociceptive input induces sensitization and changes in regulatory reflexes in animal models. In humans, postoperative somatic and visceral sensitization and the secondary effects on reflex gut motility are unclear. METHODS: Somatic and visceral sensation and gastrointestinal motility were evaluated after abdominal hysterectomies in 50 patients who were randomized to receive double-blinded postoperative 48-h infusions of morphine or tramadol. Pain scores, rectal distension, skin electric sensation and pain tolerance thresholds, and gastrointestinal transit were assessed before and after operation, during and after analgesic infusions. RESULTS: Pain intensity scores decreased similarly with morphine and tramadol infusions (total doses, 66.8+/-20 mg and 732.4+/-152 mg [mean +/- SD], respectively). Skin pain tolerance thresholds in the incisional dermatome remained similar with morphine and tramadol throughout the study. During morphine infusions, pain tolerance thresholds on the shoulder increased (P<0.05) and then decreased after discontinuation on day 4 (P<0.02) compared with before operation. Rectal distension pain tolerance pressure thresholds increased after operation during morphine infusions (P<0.05). Similar but nonsignificant trends occurred with tramadol. Orocecal and colonic transit times increased after operation with both morphine and tramadol (P<0.005), but gastric emptying was prolonged only with morphine (P = 0.03). AU motility and sensory parameters had returned to preoperative levels by 1 month after operation. CONCLUSIONS: Pain control was equally effective with morphine and tramadol infusions. No somatic or visceral sensitization was evident during morphine and tramadol infusions, but pain tolerance thresholds as markers of antinociception were increased more during morphine infusions. The significant sensitization seen only after morphine discontinuation may be due to convergent visceral input. Gut motility was prolonged significantly by visceral surgery itself and also by morphine.

Adult↗
PubMed2004

Gastrointestinal motility disturbances in celiac disease.

It is quite frequent to recognize celiac patients who show gastrointestinal motor abnormalities in clinical practice. In fact, in 30 to 60% of patients, physical examination and dyspeptic symptoms (epigastric discomfort, early satiety) suggest a gastrointestinal motility disorder. Consistent data are now available on the presence of a disturbed motility of the esophagus, stomach, small intestine, gallbladder, and colon of untreated celiac patients. Gastrointestinal abnormalities differ in different gastrointestinal districts. In fact, esophageal transit, gastric and gallbladder emptying, and orocecal transit time are delayed, while colonic transit is faster. These findings are related to the complex interactions among reduced absorption of food constituent (in particular, fat), neurologic alteration, and hormonal derangement. Motility disorders of the gut are also a predisposing factor in the development of small intestinal bacterial overgrowth and may contribute both to development of symptoms in some untreated celiacs and to the persistence of symptoms after gluten-free diet in some of them. All these alterations fortunately disappear after gluten-free diet, and patients return to well being status. Whatever the initial event in the pathogenesis of the celiac lesions may be, we know for certain at this time that gastrointestinal disturbances play an important role in the genesis of gastrointestinal symptoms in celiac disease and that surveillance for celiac disease in patients complaining of dysmotility-like dyspeptic symptoms should be increased.

Celiac Disease↗
PubMed2000

The effect of SK-896 on post-operative ileus in dogs: gastrointestinal motility pattern and transit.

The aim of this study was to investigate the effect of SK-896 (Phe-Val-Pro-Ile-Phe-Thr-Try-Gly-Glu-Leu-Gln-Arg-Leu-Gln-Glu-Lys-Glu- Arg-Asn-Lys-Gly-Gln-Hse), a new motilin analogue, on gastrointestinal motility and transit in dogs with post-operative ileus, and to compare the effects of this agent on these parameters with the effects of prostaglandin F(2alpha), a well-known gastroprokinetic agent. We used chronically implanted force transducers to measure motility and radiography of radio-opaque markers to measure transit. Infusion of SK-896 1 microgram/kg/h, for 20 min twice a day induced interdigestive migrating contractions-like motility. Infusion of prostaglandin F(2alpha), 20 microgram/kg/h, for 1 h twice a day induced continuous contractions in the distal part of the small intestine. The time of first appearance of interdigestive migrating contractions in the stomach (gastric-interdigestive migrating contractions) and the gastric emptying time of the solid marker with the administration of SK-896 were significantly less than those noted with the administration of prostaglandin F(2alpha). It appears that gastric-interdigestive migrating contractions play an important role in the transit of substances, especially solid substances, in the gastrointestinal tract. We conclude that SK-896, which induced gastric-interdigestive migrating contractions, is effective to induce early recovery from post-operative ileus.

Amino Acid Sequence↗
PubMed1986

Gastrointestinal motility following small bowel obstruction in the opossum.

The motility of the gastrointestinal tract of six opossums with total and four with partial small bowel obstruction was evaluated. Following the establishment of small bowel obstruction, the migrating myoelectric complex was substituted by a new pattern which was characterized by periods of intense spike activity interspersed with quiescent periods. In the experiments with total intestinal obstruction, the frequency and duration of the periods of intense spike activity were related to the recording site and the time after establishment of intestinal obstruction. The frequency of spike bursts in the ileum proximal and distal to the obstruction was the greatest in the first 2 days after the establishment of the obstruction, while in the antrum and proximal small bowel, the frequency of bursts of spike potentials increased gradually from the first to the fourth postobstruction day (P less than 0.01). However, there was no change in the frequency, duration, and localization of periods of intense spike activity during the 5 days following the establishment of partial intestinal obstruction. We concluded that following intestinal obstruction, the migrating myoelectric complex is substituted by a myoelectric pattern that is characterized by periods of intense spike activity interspersed with quiescent periods. In the animals with total intestinal obstruction, the periods of increased motility are initially more frequent in the bowel proximal and distal to the obstruction and afterwards in the stomach and upper small bowel.

Animals↗
PubMed1992

Effect of calcium channel blockers on postprandial gastrointestinal motility in the dog.

We have compared the ability of nifedipine and lacidipine, a new 1,4-dihydropyridine, to interfere with postprandial gastrointestinal motility. Five conscious dogs, fitted with 8 bipolar electrodes along the gastrointestinal tract, were studied. Gastrointestinal spike activity was evaluated by means of a computer system. Lacidipine (8 micrograms kg-1) was administered as an i.v. bolus immediately followed by a 10 micrograms kg-1 h-1 i.v. infusion for 3 h, starting 30 min before a standard meal. This dose of lacidipine decreased systolic blood pressure by approximately 20%. Nifedipine was used at equihypotensive doses (30 micrograms kg-1 i.v. bolus followed by 300 micrograms kg-1 h-1 i.v. infusion). Lacidipine had no effect on either gastric or intestinal postprandial spike activity. Nifedipine significantly delayed the appearance of the fed pattern and reduced the number of spikes in the small bowel, while it had no effect on gastric spike activity. We conclude that equihypotensive doses of lacidipine and nifedipine differ in their effects on the gastrointestinal tract, lacidipine having a better cardiovascular selectivity profile than nifedipine, and that the sensitivity to nifedipine varies in different parts of the gut.

Animals↗
PubMed1997

Neurotensin decreases pepsin output and gastrointestinal motility in chickens.

Two experiments were conducted to determine the effect of neurotensin on gastric secretion and gastrointestinal motility in conscious chickens. Chickens were surgically fitted with a cannula to collect secretions from the proventriculus and strain gauge transducers sutured to the gizzard, duodenum, and ileum in order to detect contractions. Peripheral intravenous infusion of physiological levels of neurotensin inhibited pepsin output from the proventriculus, but had no effect on the volume or pH of gastric secretions. Neurotensin also inhibited both the frequency and strength of gastrointestinal contractions when compared to motility patterns following infusion of isotonic 0.9% (wt/vol) saline. The frequency of occurrence of small intestinal refluxes was not affected by neurotensin. These results coupled with our earlier work, which demonstrated that neurotensin is released by the presence of oleic acid in the duodenum, indicate that neurotensin may function as an enterogastrone released by lipids in the gastrointestinal tract of the chicken. This overall inhibitory effect of neurotensin on the avian gut indicates that it is involved in the postprandial regulation of digestion, especially lipid digestion.

Analysis of Variance↗