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PubMed1987

Gastrointestinal motility in relation to spontaneous meal occurrence in domestic fowls.

The relationship between gastrointestinal (GI) motility and spontaneous feeding activity was investigated in five immature domestic hens, by recording simultaneously their feeding and contraction of the gizzard and duodenum. Different parameters of GI motility were interrelated, and gizzard contraction frequency (GCF) was used as an overall index of motility. Significant (P less than 0.05) changes in GCF relative to mealtimes varied between individual birds and between different meal length classes. The most consistent change was a rapid increase in GCF at the start of meals, followed by a decline which usually commenced before the end of long meals, but after the end of shorter ones. The increase in GCF commenced before the start of meals in one bird which had longer inter-meal intervals than the rest. There were no consistent changes in GCF at the ends of intervals or meals that might suggest a causal association between motility and hunger and satiety. It is suggested that the observed variation in GI motility may be accounted for mainly by variation in extrinsic stimulation from the vagus nerve.

Animals↗
PubMed1997

Antroduodenal motor effects of intravenous erythromycin in children with abnormalities of gastrointestinal motility.

BACKGROUND: The macrolide antibiotic erythromycin (EM) affects gastrointestinal motor activity by acting as agonist of motilin receptors located on the smooth muscle cells of the gastroduodenal tract. We studied the effect of intravenous EM on fasting antroduodenal motility in controls and children with gastrointestinal dysmotility. METHODS: EM lactobionate (rate, 3.0 mg/kg/h) was infused intravenously while antroduodenal manometry was recorded in 10 controls, in 7 patients with functional dyspepsia and in 6 patients with gut pseudo-obstruction. The mean (SD) age (years) was 5.7 (1.4), 6.5 (2.4), and 6.7 (3.2), respectively. Manometry was performed by means of a four- or six-lumen catheter introduced through the nose and perfused with a low compliance pneumohydraulic system. Five controls received EM and five received saline. RESULTS: EM, infused 5 minutes after passage of an activity front (AF), induced in controls a premature antroduodenal AF occurring 15.4 +/- 3.2 minutes after starting infusion; no motor changes were seen after saline; duration and propagation velocity of EM-induced AFs did not differ from spontaneous AFs. In patients with functional dyspepsia EM induced various patterns such as premature antroduodenal AFs, antral phase III-like pattern with short duodenal bursts or prolonged phasic antral waves and no duodenal activity. In patients with neurogenic pseudo-obstruction rare or absent antral activity with incoordinated or absent duodenal activity was induced; no contractions were elicited in two patients with myogenic pseudo-obstruction. CONCLUSIONS: It is confirmed that EM, given at subtherapeutic doses, is a powerful prokinetic agent that can have clinical applications in patients with gastrointestinal dysmotility; however, the effect of the drug seems to be influenced by the nature of the underlying disorder.

Child↗
PubMed2006

Effects of NT on gastrointestinal motility and secretion, and role in intestinal inflammation.

It is well established that interactions of neuropeptides with several cell types at various parts of the intestine are critically involved in intestinal pathophysiology. Among them, neurotensin has been identified as an important mediator in the development and progress of several gastrointestinal functions and disease conditions, exerting its effects by interacting with specific receptors that exert direct and indirect effects on nerves, epithelial cells, and cells of the immune and inflammatory systems. This review summarizes our recent understanding on the participation of neurotensin in the physiology and pathophysiology of the small and large intestine, and discusses various mechanisms that could be involved in these actions.

Animals↗
PubMed2006

Implantable neural electrical stimulator for external control of gastrointestinal motility.

Functional electrical stimulation has been suggested as a possible avenue for treating a variety of gastrointestinal motility-related disorders such as gastroparesis, chronic constipation and morbid obesity. The aims of the present study were to design a radio-frequency controlled multi-channel implantable neural gastrointestinal electrical stimulator and test it in an acute canine model. The stimulation parameters can be reprogrammed after implantation, allowing the execution of parametric studies and the investigation of their efficacy in producing controlled gastrointestinal contractions. Bipolar pulse trains of 50Hz frequency, 8-16V(pp) amplitude, 10-100% duty cycle, 1-120s duration, and 2s to 1h pause between successive stimulation sessions were delivered to the stomachs of nine dogs. The resulting contractions were measured by force transducers and digitally recorded on a personal computer. The acute studies confirmed the effectiveness of electrical stimulation in producing invoked gastric contractile activity under the control of the implantable neurostimulator.

Animals↗
PubMedDate not supplied

Influence of alcohol on gastrointestinal motility: lactulose breath hydrogen testing in orocecal transit time in chronic alcoholics, social drinkers and teetotaler subjects.

BACKGROUND/AIMS: The gastrointestinal tract is directly affected by the ingestion of alcohol. While the effect of acute ingestion of alcohol on the motility of the small intestine is well known, the influence of chronic intake of moderate amounts of alcohol and chronic alcoholism on gastrointestinal motility remains poorly understood. The aim of this study was to examine the orocecal transit (OCt) times in patients with chronic alcoholism and in "social drinkers" and compare them with a group of healthy teetotaler subjects, to assess the effects of chronic aleohol consumption on gastrointestinal transit through the application of a non-invasive technique: the hydrogen breath test. METHODOLOGY: Thirty-one alcoholics were enrolled in the study. The control groups consisted of 31 healthy social drinkers and 24 healthy teetotaler subjects. OCt time was assessed using the hydrogen breath test after the administration of 10 g of lactulose. RESULTS: The OCt time in patients with alcoholism was significantly delayed as compared with the social drinkers (p < 0.001) and healthy teetotaler subjects (p < 0.001); the OCt time in social drinkers was significantly longer than in healthy teetotaler subjects (p < 0.05). In the alcoholic group, there was no significant correlation between the OCt time and daily alcohol intake or years of alcohol addiction. CONCLUSION: Our results show a significant prolongation of the OCt time, both in patients with alcoholism and in social drinkers, as compared to teetotaler subjects. Our findings of an increased OCt time related to the consumption of alcohol could support the hypothesis of the toxic effect of ethanol on smooth muscle contractile proteins of the small intestine and on vagal function.

Adult↗
PubMed2004

Alterations of gastrointestinal motility in obesity.

All nutrients are absorbed in the gastrointestinal (GI) system, and GI motility plays a very critical role in the consumption of foods, digestion, and absorption of nutrients. Various segments of the GI tract (esophagus, stomach, and intestines) coordinate in a complex yet precise way to control the process of food consumption, digestion, and absorption of nutrients. GI motility not only regulates the rates at which nutrients are processed and absorbed in the gut but also participates in the control of appetite and satiety. Altered GI motility has been associated with various disease conditions (gastroparesis, etc.) and has been frequently observed in obese patients. The significance of these GI motility alterations in obesity is not fully understood, but they have been considered as potential contributing factors in the development and maintenance of obesity and changed eating behavior. Therapies aimed at regulating GI motility are being actively explored and applied clinically for the management of obese patients. To better understand the pathophysiology of obesity, we systematically reviewed GI motility changes observed in obese conditions. The relationship and pathological significance of these findings, as well as the potential therapies by modification of GI motility, are also discussed.

Colon↗
PubMed1997

Gastrointestinal motility problems in patients with Parkinson's disease. Effects of antiparkinsonian treatment and guidelines for management.

Gastrointestinal (GI) motility disorders are frequent in patients with Parkinson's disease, manifesting mainly as dysphagia, disorders of gastric emptying and constipation. The most likely causes of these disorders are cerebral degeneration and degeneration of the myenteric plexus. Although the effect of antiparkinsonian medication is largely overestimated, it certainly has an influence and should be adapted accordingly in patients with GI motility disorders. In particular, anticholinergic drugs should be avoided, and anamnesis, clinical examination and, if necessary, diagnostic tests performed. Domperidone, a peripheral dopamine antagonist, is the drug of choice for motility disorders of the upper GI tract, although cisapride is an alternative. In the lower GI tract, conservative therapeutic options should be used in the first instance. The administration of cisapride leads to a marked temporary improvement in symptoms in lower GI disorders, while rare forms of anism (involuntary dystonic contraction of the anal sphincter) may be treated with botulinum toxin.

Adult↗
PubMed2003

Effects of two methods of reconstruction of digestive tract after total gastrectomy on gastrointestinal motility in rats.

AIM: To compare the effects of Roux-en-Y and jejunum interposition reconstruction procedures after total gastrectomy on intestinal motility. METHODS: Fifty male Sprague-Dawley rats were randomly divided into 5 groups: the control group (C), the laparotomy group (L), the jejunal transection group (JT) where the jejunum was transected 10 cm distal from the Treitz ligament and anastomosed, the Roux-en-Y group (RY) and the jejunal interposition group (JI) after total gastrectomy. To evaluate intestinal transit, the animals were given 0.1 ml Evans Blue solution through an orogastric tube. The rats were executed by CO(2) inhalation 30 minutes later and the intestinal transmit was determined as the distance between the site of esophageojejunal anastomosis and the most distal site of small intestine colored with blue. RESULTS: One month after operation, the body weight of rats among JI and RY were almost identical (274.6+/-9.5 vs 270.4+/-10.6, P>0.05), but were significantly lighter than those of JT and L group. Four months after the operation, the body weight in the JI group increased compared to the preoperative level (345.2+/-15.7 g vs 299.5+/-8.3 g, P<0.01). However, the body weight of RY group decreased compared to preoperative (255.1+/-11.3 g vs 295.0+/-12.0 g, P<0.01). The difference was more significant at six months postoperative. Small bowel transmit time in RY was slower than that in JI group and C group (P<0.01). CONCLUSION: Changes of body weight and intestinal motility in JI group are less influenced than in RY group.

Anastomosis, Roux-en-Y↗
PubMed1998

Actions of the 5-hydroxytryptamine 1 receptor agonist sumatriptan on interdigestive gastrointestinal motility in man.

BACKGROUND: Pharmacological studies of the enteric nervous system have shown the presence of several subtypes of 5-hydroxytryptamine (5HT) receptor, which might be involved in control of the migrating motor complex. AIMS: To study the effect of sumatriptan, an agonist of enteric neuronal 5HT1p receptors, on interdigestive motility in man. SUBJECTS AND METHODS: In 12 healthy subjects, interdigestive motility was recorded manometrically in the upper gastrointestinal tract. In seven subjects blood samples were drawn every 15 minutes for radioimmunoassay of motilin and somatostatin. After two phase 3s of the migrating motor complex, 6 mg of sumatriptan was administered subcutaneously. Recording continued until two more phase 3s had occurred. RESULTS: Sumatriptan induced a premature phase 3 in the jejunum after a median of 10 (8) minutes. The duration of the migrating motor complex cycle was shortened at the expense of phase 2. After sumatriptan, plasma somatostatin concentrations were reduced and gastric phase 3s were suppressed, although median motilin concentrations and the occurrence of plasma motilin peaks were not affected. Phase 3s of the migrating motor complex preceding sumatriptan were associated with motilin peaks, while phase 3s after sumatriptan were not. Furthermore, pretreatment with sumatriptan prevented the induction of a gastric phase 3 by the motilin agonist erythromycin. CONCLUSIONS: Administration of the 5HT1P receptor agonist sumatriptan induces a premature intestinal phase 3, suppresses gastric phase 3s, prevents induction of a gastric phase 3 by erythromycin, and reduces plasma somatostatin concentrations.

Adult↗
PubMed2000

A normal gastrointestinal motility excludes chronic intestinal pseudoobstruction in children.

Gastrointestinal manometry has gained wide acceptance in the approach to patients with suspected enteric neuromuscular disorders. However, performing gastrointestinal manometry in these subjects without a previous exhaustive diagnostic evaluation is unjustified. Twelve children (median age: 7.0 years; range: 8 months-13 years), with clinical and x-ray features suggesting chronic intestinal pseudoobstruction, were referred to our unit for gastrointestinal manometry. The latter was performed with a perfused catheter for 5 hr in the fasting state and for 90 min after feeding. Data were compared with those recorded in eight age-matched controls. In all patients and controls, interdigestive motor complexes with propagated phases III were detected; a regular postprandial antroduodenal motor activity was also recorded. Patients and controls did not differ for fed antral and duodenal motility indexes, fed antroduodenal coordination, and length of duodenal phase III. Most of the patients showed short or prolonged bursts of nonpropagated activity in the fasting and/or fed states; in four cases fasting and/or fed sustained phasic activity was recorded. Manometric evidence of migrating motor complexes and postfeeding activity did not support the diagnosis of intestinal pseudoobstruction and suggested redirecting the diagnostic evaluation. Final diagnoses were: Munchausen syndrome-by-proxy (four cases), celiac disease (two cases), intestinal malrotation (two cases), Crohn's disease (two cases), multiple food intolerance (one case), and congenital chloride-losing diarrhea (one case). It is concluded that in children with suspected chronic intestinal pseudoobstruction manometric evidence of migrating motor complexes and fed motor activity excludes an enteric neuromuscular disorder and suggests a reassessment of the diagnostic work-up. Furthermore, if gastrointestinal manometry shows migrating motor complexes and postfeeding motor activity, qualitative abnormalities of the manometric tracings do not indicate an underlying enteric neuromuscular disorder and must not be overemphasized. Patients referred for gastrointestinal manometry should previously undergo an extensive diagnostic investigation to exclude disorders mimicking chronic intestinal pseudoobstruction.

Adolescent↗