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PubMedDate not supplied

Selective role of vagal and nonvagal innervation in initiation and coordination of gastric and small bowel patterns of interdigestive and postprandial motility.

Our previous studies suggested that extrinsic innervation modulates upper gut motility but is not requisite for cyclic interdigestive and postprandial motility of the stomach. However, the specific role of vagal and nonvagal extrinsic innervation in the initiation, coordination, and pattern of gastric motility in dogs after denervation of the entire upper gastrointestinal tract remains unclear. The aim of this study was to determine the role of vagal and nonvagal extrinsic innervation in control of gastric motility patterns. Mongrel dogs were subjected first to extrinsic denervation (in situ neural isolation) of the stomach, small bowel, proximal colon, liver, and pancreas but specifically maintaining vagal innervation to the stomach alone. After fasting and fed motility patterns were measured with indwelling gastric and small bowel manometry catheters, the dogs underwent transthoracic truncal vagotomy (completion of total extrinsic denervation of stomach), and motility studies were repeated. Vagal integrity to the stomach and pancreas was confirmed by means of a modified Hollander test and serum pancreatic polypeptide concentrations after the injection of exogenous insulin, respectively. We found that a cyclic motility pattern (migrating motor complex) persisted during fasting in both the stomach and the small bowel and that the patterns of the stomach and the duodenum remained temporally coordinated before and after vagotomy. However, although a cyclic phase III activity persisted in the stomach after vagotomy, the number of contractions and the motility index during phase III were decreased, and the duration between groupings of contractions was increased. No differences were noted in the duration of postprandial inhibition after feeding meals before and after vagotomy. These observations support our hypothesis that the vagal nerves are not necessary for the initiation or temporal coordination of global fasting or postprandial gastroduodenal motility patterns but are involved in modulating the pattern of contractions during gastric phase III.

Animals↗

PubMed1998

Mucosal mast cells are involved in CCK disruption of MMC in the rat intestine.

Our aim was to determine if mucosal mast cells could be activated by endogenous CCK and, as a consequence, mediate CCK actions in the small intestine. Rats were prepared for electromyography to record electrical activity in the small intestine. In another group of animals, the duodenum was perfused to measure rat mast cell protease II (RMCP II) as indicative of mast cell degranulation. Endogenous CCK release was induced by administration of soybean trypsin inhibitor (SBTI) in conscious rats or by intraduodenal perfusion of ovalbumin hydrolysate (OVH) in anesthetized rats. CCK concentration was measured by bioassay on pancreatic acini. SBTI in control rats disrupted migrating motor complexes (MMC) for >40 min. In rats treated with the mast cell stabilizer ketotifen, SBTI did not induce any change in the MMC pattern. RMCP II concentration in the duodenal perfusate significantly increased after OVH. Perfusate from ketotifen-treated animals did not show any significant increase in RMCP II values during OVH perfusion, although CCK plasma concentration was not different from the control group. Furthermore, infusion of the CCK-B receptor antagonist L-365,260 significantly blocked the increase of RMCP II concentration after OVH. Our results indicate that mucosal mast cells are degranulated by endogenous CCK release through stimulation of CCK-B receptors. Therefore mucosal mast cells participate in CCK intestinal actions.

Animals↗

PubMed1996

Higher prevalence of Helicobacter pylori infection in dyspeptic patients who do not have gastric phase III of the migrating motor complex.

BACKGROUND: So far, only a few and conflicting data are available about the possible correlation between Helicobacter pylori infection and disorders of gastrointestinal motility. METHODS: In the present study we have evaluated the interdigestive manometric recordings from the stomach and duodenum of 100 consecutive dyspeptic patients, to ascertain whether the absence of phase III of the migrating motor complex (MMC) might be associated with a different prevalence of H. pylori infection. All the patients who entered a protocol study for functional dyspepsia had endoscopic examinations of the upper gastrointestinal tract with at least two biopsy specimens from both the gastric antrum and corpus (for histologic evaluation, with search for Helicobacter-like organisms). Then, 240-min interdigestive manometric recordings, with evaluation of activity fronts (phase III of the MMC), starting from the stomach and the duodenum, were made. RESULTS AND CONCLUSIONS: The data obtained suggest that in patients without evidence of gastric phase III of MMC the prevalence of H. pylori colonization is significantly (P = 0.032) higher.

Adult↗

PubMedDate not supplied

Relationship between gastroduodenal interdigestive migrating motor complex and quality of life in patients with distal subtotal gastrectomy for early gastric cancer.

A total of 40 patients (28 males, 12 females; mean age, 56.6 years; range, 41-72 years), 1-1.5 years (mean, 1.4 years) after subtotal gastrectomy for early gastric cancer (Billroth I, D2 lymph node dissection, curability A) were divided into 2 groups according to the occurrence of interdigestive migrating motor complex (IMMC), phase III from the duodenum, and their postoperative quality of life was compared. Results were as follows: (i) patients in the IMMC, phase III positive group (28 patients) had evidently more appetite and ate more food, with less decrease in body weight compared with the IMMC, phase III negative group (12 patients); and (ii) patients in the IMMC, phase III positive group had clearly less symptoms, such as early dumping symptoms (systemic symptoms), symptoms of reflux esophagitis (e.g. heartburn, feeling of regurgitation, difficult swallowing), nausea, abdominal pain, diarrhea, abdominal distention, and borborygmus, compared with the negative group. These results showed more satisfactory quality of life in the IMMC, phase III positive group compared with the negative group.

Adult↗

PubMed1992

The patterns of motility are maintained in the human small intestine throughout the process of aging.

Intestinal disorders suggesting impaired gastrointestinal motility due to aging have been reported, but the influence of advanced age on the patterns of motility in the human small intestine is unknown. The present prospective study describes these patterns of motility in 15 healthy old subjects with a median of 84 years (range, 81-91 years). Nineteen healthy young adults served as controls. Ambulatory manometry was performed at home, with two sensors located in the proximal small intestine. Postprandial motility was induced by a standardized meal at 1800 h, and fasting motility was recorded during the subsequent night. Migrating motor complex (MMC) data were analysed by means of an expanded variance component model. Recurrent MMCs were identified during fasting in all individuals, with similar periodicity in old and young adults (p = 0.4). The propagation velocity of phase III of MMC was slower in the old subjects (6.5 +/- 0.8 cm/min versus 10.8 +/- 1.2 cm/min; p less than 0.01). Duration of postprandial motility was preserved, as were the amplitude and frequency of contractions during phase III and the postprandial state. Propagated clustered contractions were more frequently present in old subjects both after a meal (67% versus 11%; p less than 0.01) and during fasting (p less than 0.01); otherwise the patterns of motility are maintained in the human small intestine throughout the process of aging.

Aged↗

PubMed2006

Motility of the pouch correlates with quality of life after total gastrectomy.

BACKGROUND: Jejunal pouch reconstruction is used to provide reservoir function after total gastrectomy, but controversy remains regarding pouch functions and quality of life (QOL). In this study, pouch motility was studied in conjunction with postoperative QOL. METHODS: Pouch motility of 23 patients with jejunal pouch interposition after total gastrectomy was examined by manometry under fasting conditions and by an emptying test using dual-scintigraphy under postprandial conditions. Residual food was graded by endoscopic examinations. QOL was evaluated using the Gastrointestinal Quality of Life Index, and a stasis- or dumping-related symptom score. RESULTS: The pouch showed interdigestive contractile activity. Bursts of contractile activity occurred frequently and were long-lasting compared with the migrating motor complex phase III of the control jejunum. The percentage of time of contractile bursts correlated with postprandial pouch emptying (liquid: R(2) = 0.229, P < .03; solid: R(2) = 0.243, P < .02). Patients with little or no residual food had more percentage of time of contractile bursts than those with moderate residual food (P < .01). The percentage of time of contractile bursts was correlated with the Gastrointestinal Quality of Life Index score (R(2) = 0.262, P < .02), stasis-related symptoms (R(2) = 0.279, P < .01), and dumping-related symptoms (R(2) = 0.218, P < .03). CONCLUSIONS: An interposed jejunum pouch showed bursts of contractile activity that affected postoperative gastrointestinal function and patient QOL.

Duodenum↗

PubMed1995

PYY and GLP-1 contribute to feedback inhibition from the canine ileum and colon.

To explore mechanisms whereby unabsorbed nutrients in the ileum inhibit the upper gut ("ileal brake"), we perfused the canine ileum or colon and monitored phase 3 in the duodenum. Fasting motility was recorded when the ileum or colon was perfused with 154 mM NaCl, a mixed isotonic nutrient solution (Ensure), or individual nutrients (maltose, casein hydrolysates, or sodium oleate). Blood samples were collected before and during the perfusions. The ileum was also perfused with 154 mM NaCl while peptide YY (PYY) was infused by vein. In both sets of experiments, plasma levels of PYY, neurotensin, and glucagon-like peptide-1 (GLP-1) were measured. Ileal or colonic perfusion of Ensure delayed phase 3 [migrating motor complexes (MMC)] in the duodenum, inhibited ileal motility, and increased plasma levels of PYY and GLP-1. Ileal casein and oleate and colonic casein also delayed the duodenal MMC. The MMC cycle length and plasma levels of PYY were closely correlated. Intravenous PYY prolonged the MMC cycle; an intravenous dose of 100 pmol.kg-1.h-1 of PYY mimicked the effects of ileal Ensure. These results support the hypothesis that PYY, and possibly GLP-1, participate in the ileal brake. This negative feedback loop also affects the distal small bowel. The proximal colon also triggers the feedback inhibition of gut motility (colonic brake).

Animal Nutritional Physiological Phenomena↗

PubMed1995

Inhibition of the migrating motor complex by duodenal drainage in man.

The effect of varying bile acid output on fasting small intestinal motility was investigated in healthy male volunteers. Biliary output was manipulated by jejunal infusion of isotonic mannitol, which resulted in increased output, and by prolonged drainage of duodenal contents, which resulted in decreased output. Intestinal motility was measured by manometric recordings performed at four levels in the proximal small intestine. A marker dilution technique was used to measure pancreatico-biliary output. There were three experimental groups: duodenal drainage, non-drainage and control. Both duodenal drainage and non-drainage groups underwent jejunal saline infusion, followed by mannitol infusion. The control group did not receive drainage or infusions. In the drainage group, 0.41 (0.13-0.68) activity fronts of the migrating motor complex (MMC) per hour were recorded during saline infusion, but only 0.06 (0-0.19) activity fronts per hour were observed during mannitol infusion. In the non-drainage group, 0.71 (0.61-0.81) activity fronts per hour were observed during saline infusion and 0.50 (0.18-0.82) activity fronts per hour were recorded during mannitol infusion. In the control group, 0.58 (0.33-0.84) activity fronts per hour were recorded during the first 4-h session and 0.58 (0.45-0.71) activity fronts per hour during the second session. There was no difference between the number of activity fronts per hour observed in the control group and those observed in the saline infusion of the drainage group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Severe late radiation enteropathy is characterized by impaired motility of proximal small intestine.

Late radiation enteropathy (LRE) is a serious disorder, and therapeutic progress has thus far been hampered by insufficient understanding of the pathogenesis. This prospective study addresses whether alterations in proximal intestinal motility can predict the clinical severity of this disorder. Forty-one consecutive patients with chronic abdominal complaints after radiotherapy for gynecological cancer were examined by prolonged ambulatory manometry. Twenty-seven healthy adults served as controls. Impaired fasting motility was found in 12 of 41 patients (29%), and attenuated postprandial motor response after a liquid-solid meal was seen in 10 of 41 patients (24%). Postprandial delay of the migrating motor complex (MMC) was a good predictor of the degree of malnutrition (Cox regression, P < 0.01), and intensity of the MMC and postprandial motility index explained 69% (P < 0.001, multiple regression) of the variability in degree of malnutrition, assessed by weight loss and serum albumin level. The typical presentation of severe LRE was clinical symptoms suggesting intestinal pseudoobstruction, malnutrition, failure of a liquid-solid meal to induce postprandial motility, and delayed initiation and reduced intensity of MMC during nocturnal fasting. Prolonged ambulatory manometry was useful for detection of dysmotility in patients with symptoms of LRE and impaired motility of proximal small intestine seems to be a key factor in the pathogenesis of severe LRE.

Adult↗

PubMed2002

Intraduodenal capsaicin inhibits gastric migrating motor complex via an extrinsic neural reflex in conscious dogs.

The aim was to study the effect of intraduodenal capsaicin on interdigestive gastric contractions. Mongrel dogs were equipped with strain-gauge force transducers to measure gastroduodenal motility. The effects of intraduodenal capsaicin with or without pharmacological antagonists on spontaneous and motilin-induced interdigestive gastric contractions and on plasma motilin were studied in dogs with intact stomachs. The effect of intraduodenal capsaicin on gastric contractions was also studied in vagally denervated gastric (Heidenhain) pouch and vagally innervated antral pouch. Intraduodenal capsaicin inhibited spontaneous and motilin-induced gastric contractions. The spontaneous peak in plasma motilin was inhibited by intraduodenal capsaicin. The effect of intraduodenal capsaicin on motilin-induced gastric contractions was not affected by blockade of nitric oxide synthase, or by beta-adrenoceptor antagonist. Administration of alpha-adrenergic blocker inhibited basal interdigestive gastric motility. Intraduodenal capsaicin had no effect on contractions in the Heidenhain pouch but inhibited those in vagally innervated antral pouch. Duodenal afferent fibres stimulated by capsaicin inhibit gastric contractions via a nitric oxide-independent extrinsic neural reflex.

Animals↗

PubMed1993

Different interdigestive antroduodenal motility patterns in chronic antral gastritis with and without Helicobacter pylori infection.

Fasting antroduodenal motor activity was studied in 15 dyspeptic patients with chronic superficial antral gastritis and Helicobacter pylori infection (group A), 10 dyspeptic patients with chronic superficial antral gastritis without Helicobacter pylori infection (group B), and eight healthy control subjects (group C) by manometric recording of phases of the interdigestive migrating motor complex (MMC) prolonged over 240 min. A significantly lower incidence of activity fronts (phase III of MMC) starting from the antrum was observed in patients with gastritis and Helicobacter pylori infection vs patients without bacterial colonization (P = 0.013) and in these latter vs control subjects (P = 0.013). Likewise, the overall number of activity fronts was smaller in patients with gastritis than in healthy subjects (P = 0.034). Symptomatic evaluation was performed in the two groups of dyspeptic patients, without detecting any differences in frequency and severity of complaints. Our results show a significant reduction in the occurrence of interdigestive antral phase III of MMC in chronic gastritis associated with Helicobacter pylori infection, suggesting a possible relationship between fasting motility and bacterial colonization.

Adolescent↗

PubMed2003

Efficacy of real-time monitoring to determine motility in porcine small intestinal transplantation.

Orthotropic small intestinal transplantation (SIT) was performed in outbred 20 pigs. The interdigestive motor patterns were evaluated using strain gage (SG) force transducers. Seven pigs without SIT were treated as control (C) group. Based on the obtained data, the group, which could be detected the migrating motor complex (MMC) in the graft and alive with adequate oral feeding, was regarded as functional graft (FG) group, whereas the group which had available data recorded within 10 days before the death due to rejection was regarded as rejection (R) group. The MMC was analyzed using following parameters: duration; amplitude; and interval. In group FG, all parameters were almost same as group C, thus suggesting that the allograft in group FG had a normal motor function. In contrast, all parameters in group R were significantly lower than those in group FG, suggesting that the motility in group R was impaired. The SG method could monitor the real-time motility and was efficient for detecting the rejection of SIT.

Anastomosis, Surgical↗

PubMed1998

Brain Fos expression and intestinal motor alterations during nematode-induced inflammation in the rat.

Brain-gut interactions and intestinal motility were studied during pulmonary and jejunal inflammation induced by Nippostrongylus brasiliensis. Jejunal electromyographic activity was continuously recorded from day 1 before to day 28 after infection. Expression of c-fos was assessed in the brain by immunohistochemistry, and myeloperoxidase (MPO) activity was determined in lung and intestine on days 1,7,14, 21, and 28 postinfection. The cyclic intestinal motor pattern was replaced by an irregular activity from day 4, corresponding to larvae migration to the intestine, to day 14. c-fos was expressed in the caudal nucleus of the solitary tract (NTS) and lateral parabrachial nucleus (LPB) on day 1 (lung stage of N. brasiliensis) and in the medial part of the NTS, the LPB, and locus ceruleus on day 7. Pulmonary and intestinal MPO activity was increased from days 1 to 21 postinfection. During N. brasiliensis infection, c-fos expression indicates that specific and different brain nuclei are activated at the onset of pulmonary and intestinal inflammation, which is associated with motor disorders.

Animals↗

PubMed2001

Effects of alosetron on spontaneous migrating motor complexes in murine small and large bowel in vitro.

Alosetron (Lotronex) is a serotonin subtype 3 (5-HT3) receptor antagonist that alleviates symptoms of irritable bowel syndrome (IBS) in female patients. Alosetron may act centrally, involve the alteration of ascending pain sensation, or modulate peristaltic, secretory, or sensory function. To investigate further the mechanisms underlying its action and gender selectivity we recorded the effect of increasing concentrations of alosetron or ondansetron on spontaneous migrating motor complexes (MMCs) from isolated terminal ileum or colon from C57BL/6 mice. Both antagonists inhibited MMC frequency before affects on duration or amplitude. The threshold of inhibition for alosetron was 100-fold less in small intestine from females (20 nM) than from males. The opposite effect of gender was observed with ondansetron in the colon. All MMCs were abolished by either drug at 10 microM. Our results demonstrate that alosetron selectively inhibits MMC frequency in isolated preparations of murine bowel. Because contractile events in the ileum correlate with symptoms of IBS in humans, the gender selectivity of alosetron may be caused by a direct action within the small intestine.

Animals↗

PubMed1996

Mediation of altered motility in food protein induced intestinal anaphylaxis in Hooded-Lister rat.

In the Hooded-Lister rat model, food protein induced intestinal anaphylaxis disrupts the migrating motor complex (MMC) and causes an increased frequency of migrating clusters of contractions (MCCs, including giant migrating contractions (GMCs)) and diarrhea. To determine whether mast cell mediators act on enteric neurons to initiate these alterations in motility, rats were sensitized by intraperitoneal injection of 10 micrograms egg albumin (antigen (Ag)). Seven days later two jejunal manometry catheters were implanted 2.5 cm apart. On day 14, motility was recorded in fasted rats before and after intraluminal challenge with 10 mg Ag in 0.5 mL saline, both without and after pretreatment by specific antagonists. Ag challenge of sensitized animals disrupted MMCs and caused an increase in total MCCs (including GMCs) and diarrhea. Atropine or hexamethonium abolished all intestinal motility, including Ag-induced MCCs, GMCs, and diarrhea. At higher doses, agents that inhibit mast cell degranulation, cromoglycate, doxantrazole, and quercetin, did inhibit Ag-induced MCCs, GMCs, and diarrhea, but at the expense of inhibiting normal intestinal motility. Cimetidine and diphenhydramine together inhibited normal cycling of the MMC, but did not abolish Ag-induced MCCs, GMCs, and diarrhea. Methysergide was ineffective, but cinanserin and WAY 100,289 significantly inhibited, and indomethacin most effectively blocked, the Ag-induced disruption of MMCs and the increase in MCCs, GMCs, and diarrhea. Thus, the altered motility and the diarrhea observed after food protein induced luminal challenge of sensitized rats is dependent upon myenteric neuronal circuitry. The mast cell stabilizers doxantrazole and quercetin block the response because of a nonspecific anticholinergic effect. Cinanserin and WAY 100,289 partially inhibit, and indomethacin most effectively blocks, the response, suggesting that activated mast cells release prostaglandins and perhaps 5-hydroxytryptamine, which stimulate the neuronal pathway.

Anaphylaxis↗

PubMed2000

Electrophysiological and mechanical activity of the upper gastrointestinal tract after duodenoplasty or segmental resection of benign gastric outlet stenosis.

In an animal experimental study we examined the postoperative recovery of the motility of the upper gastrointestinal tract after operative treatment of a benign gastric outlet obstruction. At 45 Days after induction, a duodenal stenosis was resected in six dogs, and resolved by Finney's duodenoplasty in another six dogs. Fourteen days after segmental resection, the gastric emptying was faster [half evacuation time (T1/2) for semisolid food = 44.4 +/- 16.8 min] than following duodenoplasty [T1/2 = 56.8 +/- 25.3). Here motor migrating complexes (MMCs) started in the antrum and could be traced down to the jejunum. After segmental resection we recognized MMC only distal to the anastomosis. The duration of the whole MMC cycle (69.0 +/- 18.6 min) as well as of the single phases was significantly shorter in the resection group than after duodenoplasty (108.0 +/- 15.1 min). At 28 days after operation the differences in the electromyographic findings were smaller (82.0 +/- 15.1 min vs. 111.4 +/- 11.2 min), but still significant. Obviously humoral transmitters and the extrinsic neural system lead to good propagation of the MMC across the anastomosis, even before the intramural pathways are reestablished. Concerning the fast recovery of the motility of the upper gastrointestinal tract, duodenoplasty is superior to segmental duodenal resection.

Animals↗

PubMed1994

Hypovolemia-induced cardiovascular effects on human gastric mucosal acid and HCO3- release.

BACKGROUND: The bicarbonate ion seems to play a crucial role in mucosal acid-base regulation by generating a pH gradient that is regarded as a 'first line of defense' against acid back-diffusion. The aim of this study was to determine the effects of hypovolemia on gastric mucosal buffering capacity, as reflected by luminal HCO3- release, in human volunteers. METHODS: Central hypovolemia was induced by lower-body negative pressure (LBNP), and HCO3- release was measured by using a perfusion system based on continuous recording of the pH and PCO2 of gastric aspirate. The response to LBNP was related to concomitant cardiovascular effects, to gastric pH, and to the current phase of the migrating motor complex (MMC). RESULTS: At an acid gastric pH, LBNP induced a slight but statistically significant reduction in luminal HCO3- release (-27 +/- 10%, p < 0.05). The magnitude of the response was significantly correlated with the degree of reflex tachycardia. A larger and less variable response (-78 +/- 4%, p < 0.01 versus control group) was seen when luminal pH was increased by ranitidine pretreatment. The effect of LBNP on HCO3- release was statistically significant only during the early and middle parts of the MMC cycle. CONCLUSIONS: The results indicate that hypotension may reduce gastric mucosal buffering capacity, probably by activation of a sympathetic reflex. The magnitude of this response seems to depend on: 1) the degree of baroreceptor unloading; 2) luminal pH; and 3) the current phase of the MMC.

Adult↗

PubMed1996

Effects of intraduodenal air insufflation on sphincter of Oddi motility in conscious dogs.

To investigate effects of intraduodenal air insufflation on sphincter of Oddi motility, manometric recordings were obtained during fasting from the sphincter and duodenum in four conscious dogs with duodenal cannula. At 40% of the mean cycle length of the migrating motor complex predetermined from baseline recording, 160 ml of air was injected into the duodenum. In both the sphincter and duodenum, air insufflation produced premature phase III-like activity in seven of 20 experiments (35%) or nonspecific excitatory reaction in eight (40%). In the remaining five experiments (25%), the sphincter exhibited a transient inhibitory response, while the duodenum showed the nonspecific excitatory reaction. Basal pressure of the sphincter increased immediately after air insufflation in 90% of the 20 experiments. The mean basal pressure increased from 12.3 +/- 1.6 mm Hg to 22.4 +/- 2.1 mm Hg (P < 0.0001) and minimum basal pressure from 2.9 +/- 0.9 mm Hg to 4.7 +/- 0.8 mm Hg (P < 0.001). These results indicate that intraduodenal air insufflation does affect motility of the sphincter of Oddi and duodenum in conscious dogs.

Air↗