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Relationship of fasting gastroduodenal motility to the sleep cycle.

The cyclical pattern of fasting gastroduodenal contractile activity, termed the "migrating myoelectric complex," was studied during sleep in 9 healthy human subjects over 41 nights. Power spectral analysis revealed that peaks in the region of 11-16 cycle/day were present for sleep stage changes, duodenal contractile activity, and body movements during sleep. Gastric contractile activity, however, peaked between 7 and 11 cycle/day. Average coherence values between sleep stage changes and duodenal contractile activity were significant (p less than 0.05) and indicated an interrelationship between these two patterns of activity. This was most clearly demonstrated at frequencies below 14 cycle/day. Average coherence values between body movements during sleep and duodenal contractile activity were also significant (p less than 0.05) at approximately 18 cycle/day. These results support the concept of an oscillator, external to the gut and possible central in location, that influences several functions including migrating myoelectric complex periodicity.

Adolescent↗

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↗

Motility of the small intestine: a look ahead.

Motility of the gastrointestinal tract has become an important discipline of gastroenterology. In this paper we review important observations made during the early development of this discipline, note the current level of knowledge, and look ahead to some of the questions we believe will be addressed in the near future. Is the slow wave the action potential equivalent of the longitudinal muscle layer? How does the migrating action potential complex interrelate with the migrating myoelectric complex--are they two separate complexes under different control mechanisms? How do the myenteric plexus neurons relate to these complexes? Does the muscularis mucosa control the contraction and relaxation of the villous tips? Is there a finite area in the small intestine that can function as the pacemaker? How important are substances within the lumen in controlling motility? Finally, we emphasize the importance of structure and function of the plexus neurons in motility studies. We also stress the importance of collaboration and a multidisciplinary approach for future understanding of the mechanisms of the small intestine in health and disease.

Action Potentials↗

Effect of Escherichia coli heat-labile enterotoxin on the myoelectric activity of the duodenum in weaned pigs.

The objective of the present study was to elucidate the effect of subclinical doses of Escherichia coli heat-labile enterotoxin (LT) on the antro-duodenal myoelectric activities of weaned pigs. Twelve weaned pigs were surgically implanted with three pairs of electrodes on the antrum 3 cm before the pylorus, 5 and 20 cm after the pylorus on the duodenum, respectively. An infusion cannula was inserted into the duodenum between duodenal electrodes. Using a wireless telemetry recording system, an electromyography (EMG) tracing lasting at least 24 h was recorded as the control, then another 24-h EMG recording was performed with a bolus intraduodenal infusion of LT (0.1 and 0.5 microg/kg b.w.). After a 1- to 2-day break, a 5-fold higher dose of LT was administered using the same protocol. In the antrum, LT administration barely modified the EMG signal. However, in the duodenum it prolonged the duration of phase II and the migrating myoelectric complex (MMC) cycle when compared with the control. The number of duodenal MMC cycles was also significantly diminished. Moreover, the migrating velocity of phase III was increased. The migrating action potential complex (MAPC) was present both without and with LT, but occurred more frequently following LT administration. In conclusion, LT caused a dose-dependent, lagged alteration in the duodenal MMC in weaned pigs, involving a reduction of the MMC number by lengthening phase II, increased phase III migration velocity, and increased MAPC frequency. The disturbances did not, however, result in diarrhoea and may reflect the induction of a local protection mechanism of the gut to expel unwanted foreign content from the lumen of the upper gut.

Animals↗

Chronic bile diversion does not alter canine interdigestive myoelectric activity.

Previous studies have suggested that the cyclic entry of bile into the duodenum during fasting regulates interdigestive patterns of motility by releasing the putative regulatory hormone motilin. Our aim was to determine if cyclic secretion of bile into the duodenum regulates interdigestive myoelectric activity and plasma motilin concentrations. Six dogs were prepared with gastric and intestinal serosal electrodes. Myoelectric activity was measured during fasting and after a meal before and after reoperative translocation of the entrance of the bile duct to the mid-jejunum. The characteristics of the migrating myoelectric complex (MMC) and conversion to a postprandial pattern were similar before and after bile duct translocation. The period (112 +/- 5 vs 109 +/- 10 min; mean +/- SEM), migration velocity of phase III through the duodenum (8.9 +/- 1.2 vs 6.8 +/- 0.5 cm/min), and duration of individual phases of the MMC in the stomach, duodenum, and jejunum were not altered significantly (each P > 0.05) by chronic diversion of bile from the duodenum. Plasma motilin concentrations were similar before and after bile duct translocation (P > 0.05), continued to cycle temporally with the MMC, and peak concentrations occurred during phase III and were greater than during phases I and II (P < 0.01). We conclude that the presence of bile in the lumen of the duodenum does not regulate interdigestive myoelectric patterns of the canine upper gut or the cyclic release of motilin.

Animals↗

Small bowel myoelectric activity in peritonitis.

Peritonitis is associated clinically with paralytic ileus, but the physiologic mechanisms of the effects of peritonitis on bowel myoelectric activity have not been explored. Bipolar electrodes were inserted into the rats, and myoelectric control recordings were obtained for 4 h/d for 5 consecutive days. Peritonitis was then induced, and myoelectric recordings were again obtained. Each animal served as its own control. Prior to induction of peritonitis (control), phase I, II, and III myoelectric activity was present in all recordings. The cycle duration of the migrating myoelectric complex was 17.17 +/- 0.39 minutes, and the migration velocity of phase III was 0.61 +/- 0.02 cm/min. The most striking feature during peritonitis was the complete inhibition of phase II activity. Phase III activity, however, was present with a cycle duration of 16.69 +/- 0.42 minutes. This study shows that some features of intestinal myoelectric activity (phase III) are preserved during episodes of peritonitis, and others are changed (phase I) or lost (phase II). Disappearance of phase II activity in this type of ileus emphasizes its importance in normal small bowel motility.

Animals↗

Myoelectric activity and absorptive capacity of rat small intestinal isografts.

The effect of transplantation on small intestinal absorption, digestive capacity, myoelectric activity, and morphology was assessed in inbred Lewis rats. Electrodes were sutured to the duodenum and isografted jejunoileum or to the native jejunoileum in controls. The frequency of migrating myoelectric complexes (MMCs) in the duodenum was 3.3 +/- 0.3/hr in controls and 1.8 +/- 0.4/hr in transplants (P < 0.05). MMC frequency in the jejunoileum was 5.1 +/- 1.3/hr in controls and 3.2 +/- 0.9/hr in transplants (P > 0.05). MMCs appeared to migrate from the duodenum to the jejunoileum 80 +/- 3% of the time in controls and 59 +/- 7% of the time in transplant rats (P < 0.05). Absorption in the transplanted jejunoileum demonstrated a 35-40% decrease in glucose and electrolytes absorption. Villus height and number of nuclei per villus was reduced. Intestinal length (dry) was 103 +/- 6 cm for controls and 51 +/- 3 cm for transplant rats (P < 0.05). Brush border sucrase activity was unchanged. We conclude that small intestinal isografts display similar myoelectric activity as controls, but the decreased absorptive capacity and villus height may require longer segments of intestine to be transplanted in order to support normal nutrition.

Animals↗

Gastrointestinal myoelectric activity in a child with gastroschisis and ileal atresia.

Gastroschisis is frequently associated with intestinal atresia and alterations in gastrointestinal function. The authors studied gastric and small bowel myoelectric activity in a child who had a complex course and prolonged inability to tolerate oral intake after staged repair of gastroschisis and an associated ileal atresia. The child remained unable to tolerate oral intake after repair of the atresia and was reexplored 3 months later to rule out a partial small bowel obstruction, with simultaneous placement of serosal electrodes on the stomach and proximal small bowel. Persistent gastric dysrhythmias were observed postoperatively, and the child was unable to tolerate gastrostomy tube feedings. Abnormalities were also seen in small bowel motility, including retrograde propagation of activity fronts of the migrating myoelectric complex. However, the intestine converted to a fed myoelectric pattern with tube feedings, and the child was subsequently able to tolerate feedings via a tube placed directly into the small bowel. The authors conclude that myoelectric recordings via implanted electrodes are safe and feasible in children, and may give information regarding underlying motility alterations. The ultimate clinical role of myoelectric recordings in treating children with suspected motility disorders will require further study.

Abdominal Muscles↗

Evaluation of the myoelectrical activity of the equine ileum infected with Strongylus vulgaris larvae.

Five weanling ponies were subjected to an intensive 6-week deworming program after which 4 Ag-AgCl bipolar electrodes were implanted surgically on the distal ileum. For 3 hours each day for 5 consecutive days, ileal myoelectrical activity was recorded from fed ponies under 3 sequential conditions: preinoculation, after oral administration of 1,000 killed Strongylus vulgaris infective larvae (3 ponies), and after oral administration of 1,000 live S vulgaris infective larvae. Recordings were analyzed for slow wave frequency, percentage duration of phases I, II, and III of the migrating myoelectrical complex (MMC), and the frequency of distinct, rapidly migrating action-potential complexes within phase 2 of the MMC. After administration of live and killed infected 3rd-stage larvae, there was a marked increase in the number of disrupted phase III complexes, and a significant (P less than 0.001) increase in the number of migrating action-potential complexes. In addition, after inoculation of live 3rd-stage larvae, there was a significant increase (P less than 0.001) in the percentage of time that the MMC was occupied by prolonged periods devoid of spike activity (phase I). The results indicate that S vulgaris larval mucosal penetration and submucosal migration can cause changes in ileal myoelectrical activity that could cause colic, and that larval antigen alone within the lumen may disrupt ileal motility.

Animals↗

Influence of microbial species on small intestinal myoelectric activity and transit in germ-free rats.

The effect of an intestinal microflora consisting of selected microbial species on myoelectric activity of small intestine was studied using germ-free rat models, with recording before and after specific intestinal colonization, in the unanesthetized state. Intestinal transit, neuropeptides in blood (RIA), and neuromessengers in the intestinal wall were determined. Clostridium tabificum vp 04 promoted regular spike burst activity, shown by a reduction of the migrating myoelectric complex (MMC) period from 30.5 +/- 3.9 min in the germ-free state to 21.2 +/- 0.14 min (P < 0.01). Lactobacillus acidophilus A10 and Bifidobacterium bifidum B11 reduced the MMC period from 27.9 +/- 4.5 to 21.5 +/- 2.1 min (P < 0.02) and accelerated small intestinal transit (P < 0.05). Micrococcus luteus showed an inhibitory effect, with an MMC period of 35.9 +/- 9.3 min compared with 27.7 +/- 6.3 min in germ-free rats (P < 0.01). Inhibition was indicated also for Escherichia coli X7 gnotobiotic rats. No consistent changes in slow wave frequency were observed. The concentration of neuropeptide Y in blood decreased after introduction of conventional intestinal microflora, suggesting reduced inhibitory control. Intestinal bacteria promote or suppress the initiation and aboral migration of the MMC depending on the species involved. Bacteria with primitive fermenting metabolism (anaerobes) emerge as important promoters of regular spike burst activity in small intestine.

Action Potentials↗

Investigations of the migrating motor complex in domestic turkeys.

The motor correlate of the migrating myoelectric complex (MMC) was characterized in domestic turkeys, and feeding state, age, sex, and time of day were examined as possible factors influencing the motor activity observed. Strain gauge transducers, and in a few birds Ag-AgCl bipolar electrodes, were implanted on the caudoventral thin muscle of the muscular stomach, the duodenum, ileum, cecum, and colon. Contractility was recorded for 8-10 h per bird on alternating days for 2-3 wk, except in birds involved in four 24-h recording sessions during a 2-wk period. Intense motor activity characteristic of phase III of the MMC occurred only in the ileum; other phases could not be identified. The duration, propagation velocity, and percent of cyclic motor patterns propagating from one site to another were similar to those reported in other galliform species. The occurrence of cyclic motor activity appeared to be related to food consumption; the number of motor patterns occurring during an intense feeding session was less than the number observed 1.5-2 h after feeding. In addition, more motor patterns were recorded in fasted poults during the light period than in the dark; however, the reverse was observed in juveniles fed ad libitum. Cyclic motor activity recorded in fasted 18-wk-old birds was of longer duration than that in fasted 8-wk-old birds. No statistically significant differences were noted in the cyclic motor patterns of male vs. female poults.

Animals↗

Small intestinal motility disorders in preruminant calves chronically fed a diet based on antigenic soya: characterization and possible mediators.

Intestinal motility disorders and some mediators implicated in these disorders were studied in preruminant calves that had been chronically fed a diet containing an antigenic heated soyabean flour (HSF) for 3 months. The calves in the present study had previously been shown to present strong immune reactions against soyabean proteins, as assessed through plasma antibody titres, direct skin tests and in vitro lymphoproliferation. Four of these calves sensitive to soya were fitted with an abomasal catheter and wire electrodes on the jejunum. Myoelectric activity was recorded over 7 h following test meals containing skim milk powder (SMP), HSF or a non-antigenic hydrolysed soya protein isolate (HSPI). The pattern of myoelectric complexes migrating to the jejunum was regular with SMP (mean durations of phases I, II and III: 26, 38 and 5.28 min, respectively). With HSF, diarrhoea appeared, and the total duration of phase I decreased from 149 to 68 min (P < 0.01) while that of phase II increased from 239 to 328 min (P < 0.01). The mean duration of phase III decreased from 5.3 to 3.9 min (P < 0.01). These changes, including diarrhoea, were substantially reversed by feeding HSPI. When promethazine, a H-1 histamine receptor antagonist, was administered i.v. prior to feeding HSF the number of phases I tended to decrease and diarrhoea virtually disappeared. In contrast, indomethacin, a cyclooxygenase inhibitor, had limited effects on motility patterns and diarrhoea. These disorders were partially reproduced by i.p. administration of platelet-activating factor (PAF) prior to feeding with SMP. These findings suggest that calves chronically fed antigenic soya suffer from immune-mediated motility disorders which are linked to histamine action via H-1 receptors, and possibly with PAF. The role of arachidonic acid catabolites of the cyclooxygenase pathway is probably minor.

Allergens↗

Role of gastrin and insulin in postprandial disruption of migrating complex in dogs.

The duration of the disruption of the interdigestive migrating myoelectric complex (MMC) by various test meals in dogs was correlated with changes in serum gastrin and insulin levels. The test meals consisted of milk protein, sucrose, arachis oil and medium chain triglycerides (MCT). Intravenous infusions of glucose 20% were also used. Electrical activity of the small intestine was registered by means of electrodes implanted over the entire length of the gut. Hormones were assayed by radioimmunoassay techniques. The insulin level rose significantly after both the glucose infusion and the sucrose meal. The rise was small after the milk protein meal and nothing after arachis oil and MCT. Gastrin level was not changed by arachis oil or MCT and rose slightly after sucrose and milk protein. The MMC was not disrupted by glucose infusions, but was disrupted for 5--7 h by archis oil and for 6--12 h by MCT. We conclude that in dogs neither gastrin nor insulin have an important role in the mechanism of disruption of the MMC after feeding.

Action Potentials↗

Colonic migrating and nonmigrating motor complexes in dogs.

We report here the characteristics of a cyclic motor activity in the colon of conscious dogs and its relationship to small intestinal migrating motor complexes (MMCs). The colonic motor activity was recorded by four equispaced strain gauges and small intestinal myoelectric activity by four equispaced bipolar electrodes. The colonic motor activity was characterized by rhythmic bursts of contractions. The mean durations of bursts of contractions varied from 7.0 to 11.5 min at the four colonic recording sites. Those bursts of contractions which migrated over at least three recording sites were called colonic migrating motor complexes (CMMCs). All other patterns of bursts of contractions were called colonic nonmigrating motor complexes (CNMCs). A total of 160 CMMCs were recorded during a total recording period of 132 h; 151 CMMCs migrated caudad and 9 orad. The mean period of caudad migrating CMMCs was 53.3 +/- 5.4 (SE) min, and their mean migration time was 11.3 +/- 1.2 (SE) min. The onset of CMMCs was not temporally related to the onset of small intestinal migrating myoelectric complexes in the duodenum or their arrival in the terminal ileum. CMMCs did not have phases I to IV like those of small intestinal MMCs, but two consecutive CMMCs were separated by a quiescent state or by one or more randomly occurring bursts of contractions (CNMCs).

Action Potentials↗

Disruptive effect of test meals on interdigestive motor complex in dogs.

The disruptive effect of food and food components on the migrating myoelectric complex (MMC) was studied in conscious dogs. Three types of test meals were fed, and the interval between feeding and the reappearance of the first phase III of the MMC was determined. When commercial dog food was used a linear relation was observed btween the quantity of food (expressed as kcal/kg body wt) and the duration of the disruption of the MMC. Equicaloric amounts of the three major food components disrupted the MMC pattern for periods of time that were related to the nature of the food: the effect of arachis oil lasted longer than that of sucrose and much longer than that of milk protein. Medium chain triglycerides had a potent disruptive effect. Mixtures of these food components produced a disruptive effect that could not be calculated from the individual effect of each component. Phase III of the first and second MMC after feeding started at a lower level of the intestine than after a long fast. The duration of disruption of the MMC after a meal depends much more on the physicochemical composition of the food than on its volume or amount of calories.

Action Potentials↗

Distribution of muscarinic receptor subtypes in rat small intestine.

Despite its great promise, small intestinal transplantation in some patients is complicated by difficult postoperative management. The reasons for this are complex. In a rat model of small intestinal transplantation, frequencies of migrating myoelectric complexes during fasting are reduced in ileal isografts and muscarinic receptor density is decreased. We hypothesized that the distribution of muscarinic 1 receptors localized to enteric neurons is altered after small intestinal transplantation. Distal small intestine was orthotopically transplanted in Lewis-to-Lewis donor-recipient combinations. At 3 months, transplanted and normal ileum was obtained to prepare membrane fractions. [N-methyl-3H]Scopolamine served as ligand, while scopolamine methylbromide, pirenzepine, and methoctramine were used in competitive homologous and heterologous displacement experiments. Receptor subtype models were examined by nonlinear regression analysis. In normal and transplanted ileum, heterologous displacement was consistent with three site models (P < 0.05). In normals, the muscarinic 1 receptor subtype was most abundant, with a relative distribution of 69 to 78%. There was a relative distribution of 13 to 16% for muscarinic 3 receptor subtype. After transplantation, the muscarinic 1 subtype decreased to a mean of 45% but the muscarinic 3 subtype increased to a mean of 42%. Using pirenzepine, mean pKD values were not different between the two groups. It is concluded that the decrease in muscarinic 1 receptor subtype after transplantation could be related to neuronal cell loss or to downregulation of the expression of muscarinic 1 receptors. The results did not support defective posttranslational processing of receptor proteins.

Animals↗

Regulation of plasma motilin by opioids in the dog.

In the first part of this study, we compared the effects of morphine and trimebutine, two opioid receptor agonists, on small intestinal motility and plasma motilin in dogs. Morphine (100 micrograms/kg iv for 10 min) induced first a typical vomiting myoelectric profile followed subsequently by a migrating electrical activity mimicking phase III of the migrating myoelectric complex; trimebutine (5 mg/kg iv for 10 min) initiated only a migrating phase III-like activity. Despite their different initial contractile effects, both agents induced a significant and similar rise in plasma motilin that preceded the beginning of the premature phase III. In the second portion of the study, naloxone, an opioid receptor antagonist, was infused to verify the influence of endogenous opiates on plasma motilin and on the migrating motor complex. Naloxone (2 mg/kg, then 0.5 mg.kg-1.h-1 iv) delayed significantly the cyclic recurrence of plasma motilin peak increases and of the phase IIIs. In some animals, where naloxone abolished the phase IIIs, the amplitude of the motilin peak increases was significantly diminished. These results suggest 1) that opioid administration increases plasma levels of motilin by a mechanism that is independent of the intestinal contractile activity, and 2) that endogenous opioids could be physiological inducers of plasma motilin increases in the conscious dog.

Action Potentials↗

Characteristic motor activity of the gastrointestinal tract in fasted conscious dogs measured by implanted force transducers.

Gastrointestinal contractile actiivity from the gastric body to the terminal ileum in conscious dogs was continuously recorded for several weeks by means of chronically implanted strain-gage force transducers. It was found that the 24-hr changes in the gastrointestinal contractile activity consisted of the two different major patterns, the digestive and interdigestive patterns. In the interdigestive state, a cyclic, recurring, caudad-moving band of strong contractions starting in the stomach and the duodenum and traversing the entire length of the small intestine was observed. When one band of strong contractions reached the distal ileum, another developed in the stomach and the duodenum again and propagated in a caudad direction. Such recycling episodes interrupted by long-lasting quiescence repeatedly occurred until the next meal. These characteristic contractile activities observed in our dogs are identical with the interdigestive myoelectric complex of the stomach and the small bowel recently reported by Code and Marlett (5). Four sequential phases (I-IV) of the migrating myoelectric complex, defined in terms of action potential activity, seem to correspond to the resting (quiescence), preceding irregular contractions, strong contractions, and subsiding contractions observed in the present study, respectively. Function and control mechanism of the interdigestive contractile activity were discussed.

Action Potentials↗