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PubMed1986

Ontogenic development of gastrointestinal motility: IV. Duodenal contractions in preterm infants.

Duodenal motility was studied by intraluminal manometry in 27 healthy infants of 26 to 42 weeks, gestational age. The frequency of contractions, the number of contractions per burst, and the intraluminal peak pressure during contractions all increased during a narrow postconceptual period, 29 to 32 weeks, regardless of length of gestation before birth. Antenatal beta-methasone administration to the mothers of 11 additional infants of 26 to 32 weeks gestational age was associated with increased duodenal contraction rate, number of contractions per burst, and intraluminal peak pressure compared with infants of similar gestational age whose mothers did not receive beta-methasone. The maturational effect of beta-methasone on duodenal motility was most pronounced in infants whose gestational age at birth was 26 to 29 weeks. Seven infants of 31 weeks' or longer gestational duration who had a CNS abnormality or insult had fasting duodenal contraction rates that were less than one half of the rate for normal infants of similar gestational age. These observations suggest that neonatal duodenal motility undergoes marked maturational changes between 29 and 32 weeks after conception and that these changes may be inducible before 29 weeks by corticosteroid administration. An intact CNS appears to be required for full expression of the maturational changes.

Betamethasone↗

PubMedDate not supplied

Investigation of rocking as a postoperative intervention to promote gastrointestinal motility.

Debilitating gas pain is a common sequel for patients who have undergone abdominal surgery. Resulting from impaired motility induced by the mechanical and psychological stresses of surgery, as well as the effects of anaesthetic and analgesic agents, accumulated gas in the bowel often leads to longer and more unpleasant hospital stays. In this article, the authors describe ongoing research aimed at mediating gas effects in women post-hysterectomy. Using rocking as a moderator of the surgical stress response, the study hypothesizes a more rapid resumption of GI motility with decreased gaseous distention and associated pain, and less emotional distress for patients who follow a regimen of rocking in addition to ambulation. A sample of 34 patients is being studied, and data are being collected during a preadmission process and 5 postoperative days.

Adolescent↗

PubMed1985

[Changes in gastrointestinal motility in the diabetic].

The frequency and pathophysiology of disorders of gastro-intestinal motility associated with diabetes are poorly understood. Gastroparesis is often misdiagnosed, although it can be responsible for diabetic instability. Constipation is the most frequent gastro-intestinal symptom, although the patient may present alternating episodes of diarrhoea and constipation. The pathophysiology of these disorders is still poorly understood. It could well be caused by diabetic neuropathy.

Constipation↗

PubMed2005

Control of gastrointestinal motility by the "gut brain"--the enteric nervous system.

The enteric nervous system (ENS) as the "brain of the gut" is pivotal for normal muscle activity in the gut. Neuronal circuits within the ENS are designed to control gut motility independent of central inputs. To fulfill this task the ENS contains all necessary elements for coding mechanical and chemical stimuli, interneuronal communication and efferent output to the muscle. This review provides a summary of the ENS circuits that control muscle activity, the main transmitters and neuromodulators involved and the functional implications for the normal and diseased gut.

Digestive System↗

PubMed2006

Ghrelin does not stimulate gastrointestinal motility and gastric emptying: an experimental study of conscious dogs.

Ghrelin is a peptide that was discovered in endocrine cells of the stomach. However, its action in regulating the fasted and fed motor activity of the digestive tract is not fully understood. In the present study, we examined the effects of an intravenous (i.v.) injection of canine ghrelin on the physiological fasted and fed motor activities in the stomach, duodenum, jejunum and colon of freely moving conscious dogs. An i.v. injection of canine ghrelin released growth hormone in a dose-dependent manner; however, it did not stimulate the motor activity of the digestive tract in either the fasted or the fed state. Moreover, an i.v. injection of high-dose canine ghrelin significantly reduced the motility index in the gastric body in the fasted state. Ghrelin did not accelerate gastric emptying, either. These results differ from previous reports dealing with rodents. It is significant that such results were obtained in research with dogs, which are larger animals.

Animals↗

PubMed1991

Closing remarks. Ondansetron: effects on gastrointestinal motility.

Ondansetron (GR 38032F), a 5-hydroxytryptamine-3 (5-HT3) receptor antagonist, is a highly effective and safe drug for the prophylaxis and treatment of emesis induced by various chemotherapy regimens in cancer patients. Recent studies have shown that ondansetron is also effective in post-anaesthesia and radiation-induced nausea and vomiting. When compared with high-dose metoclopramide, ondansetron appeared to be superior. Furthermore, ondansetron has been shown to improve stool consistency and to reduce stool frequency in patients with diarrhoea-predominant irritable bowel syndrome.

Gastrointestinal Motility↗

PubMed1987

Loperamide--an opiate receptor agonist with gastrointestinal motility effects.

Loperamide is an opiate agonist, also exerting activity by inhibiting the action of calmodulin. The mode of action in the clinic is probably mainly due to its action on opiate receptors, since the effects of loperamide can be reversed by naloxone. The exclusive action in the gut is explained by the specific distribution of loperamide with extensive distribution to the gut and minimal influence on opiate receptors in CNS. Loperamide is well absorbed after oral administration and extensively metabolized. The pharmacokinetic properties are linear over a wide dose range.

Gastrointestinal Motility↗

PubMed1987

The action of trimebutine maleate on gastrointestinal motility is mediated by opiate receptors in human subjects.

The effects of trimebutine on interdigestive motor activity of the small intestine and the colon were studied in healthy volunteers. Trimebutine induced in all subjects phase III-like motor complexes, which were similar to spontaneously occurring phase III complexes of the interdigestive cycle in antrum and duodenum. Trimebutine-induced complexes were suppressed by naloxone. Trimebutine and/or naloxone had no consistent effect on interdigestive contractile activity in the colon.

Adult↗

PubMed1994

[Gastrointestinal motility and possibilities of influencing it].

The authors discuss factors which influence the motility of the smooth muscles in the pancreatobiliary region. They investigated some clinical and laboratory parameters after administration of the selective antagonist of calcium influx-Pineverium bromide-Dicetel. The drug influenced significantly in a positive way nausea, flatulence, pain and chronically elevated amylases. The authors mention a cycle of possible neurohumoral changes with which specific calcium channel antagonists could interfere.

Adult↗

PubMed1998

Clinical and upper gastrointestinal motility features in systemic sclerosis and related disorders.

OBJECTIVE: The aim of this study was to characterize the clinical and motility findings in 62 patients with systemic sclerosis or related disorders referred for evaluation of upper gastrointestinal (GI) symptoms. METHODS: Methods included retrospective clinical record review and quantitation of esophageal, LES antral, and duodenal motility (3 h fasting, 2 h fed) were compared with results of 10 symptomatic patients with normal gastric emptying. RESULTS: A total of 46 patients had systemic sclerosis, eight mixed connective tissue disease, and eight polymyositis-systemic sclerosis overlap; systemic manifestations were almost invariably present. GI symptoms were: heartburn (77%), nausea/vomiting (58%), dysphagia (61%), diarrhea (53%), constipation (31%), and fecal incontinence (13%). Anatomical studies showed esophageal erosions or GERD (53%), aperistalsis (34%), stricture (29%), and Barrett's metaplasia (16%); megaduodenum, small bowel dilation, or diverticulae (42%); and pneumatosis intestinalis (8%). A total of 36 patients underwent esophageal and 26 esophagogastrointestinal manometry. Postprandial antral motility index was abnormal in 22 of 26; amplitudes and frequency in the antrum (34 +/- 3 mm Hg and 0.6 +/- 0.1/min, respectively) and duodenum (7.3 +/- 0.9 mm Hg and 1.8 +/- 0.5/min) were significantly lower than controls (p < 0.05). CONCLUSION: In patients with GI symptoms associated with systemic sclerosis and related disorders, the amplitude and frequency of intestinal contractions are typically <10 mm Hg and <2/min. Antral amplitude is low (<40 mm Hg) when antral hypomotility is observed.

Adolescent↗

PubMed1994

Abnormal gastrointestinal motility in patients with celiac sprue.

No study to date has objectively investigated whether the motor behavior of the small bowel is abnormal in celiac sprue. The purpose of this study was to systematically address this topic by means of intraluminal pressure recordings in a series of such patients. Sixteen subjects (nine adults, seven children, age range 2-69 years) with celiac sprue were recruited and studied while untreated. Manometric examination was carried out for 6 hr during fasting and 3 hr after a meal. Adult celiac patients displayed a significantly (mean +/- SEM) greater frequency of migrating motor complexes in comparison to controls during fasting (4.44 +/- 1.6 vs 2.45 +/- 0.20, P < 0.01), whereas no differences were found in the pediatric group with respect to this variable. Fasting motor abnormalities, chiefly represented by discrete clustered contractions, giant jejunal contractions, and bursts of nonpropagated contractions, were discovered in a high percentage in both groups of celiac subjects (89% in adults and 44% in children, respectively). Similar abnormalities were observed in the postprandial period, especially in adults. In conclusion, patients with celiac sprue frequently display discrete gastrointestinal motor abnormalities, which though perhaps nonspecific may account for several symptoms complained of by such patients.

Adult↗

PubMed2005

Effect of an aqueous extract of dried immature fruit of Poncirus trifoliata (L.) Raf. on intestinal transit in rodents with experimental gastrointestinal motility dysfunctions.

The effect of an aqueous extract of the dried immature fruit of Poncirus trifoliata Raf. (Rutaceae) (PF-W) on gastrointestinal (GI) motor function was investigated by measuring the intestinal transit rate (ITR) of Evans blue in rats and mice with experimental GI motility dysfunctions (GMDs). GMD was induced by appropriate surgery or by the administration of acetic acid, atropine, L-DOPA, or morphine to the animals. The ITR in these GMD animals was significantly retarded compared to normal animals. The retardation, however, was significantly inhibited by the intragastric administration of PF-W (0.1-1g/kg) in a dose dependent manner for all GMD models except for L-DOPA-induced GMD. The above results suggest that PF-W has the potential for development as a prokinetic agent that may prevent or alleviate GMD in human patients.

Animals↗

PubMed1984

Symposium on upper gastrointestinal motility disorders. Gastric motor disorders: an overview.

Disturbances of gastric emptying are being increasingly recognized as causes of clinical problems such as chronic nausea, vomiting, and abdominal pain. Although much remains to be learned, enough information is available to enable the practicing physician to develop an approach to diagnosis and management of these often difficult problems. We review here relevant physiologic concepts of gastric motor activity during fasting and feeding, as well as its controlling mechanisms. These concepts are then applied to develop a rational classification of gastric motor disorders which incorporates clinical as well as pathophysiologic information. Further, we review pertinent diagnostic studies (including gastric emptying tests, manometry, and electrophysiologic measurements) and therapeutic approaches.

Electrophysiology↗

PubMed1988

Role of the duodenum in the control of canine gastrointestinal motility.

This study was designed to determine the role of the duodenum in controlling the interdigestive migrating motor complex of the canine stomach and small intestine. The motility patterns of 4 dogs were studied before and after resection of the entire duodenum with reimplantation of bile and pancreatic ducts. Before duodenectomy, plasma concentrations of motilin and pancreatic polypeptide varied cyclically with the migrating motor complex. After duodenectomy, the migrating motor complex was abolished in the stomach in 3 of the 4 dogs during fasting. The other dog demonstrated what appeared to be an intermittent cyclic increase in gastric contractile activity, but with markedly abnormal characteristics and at irregular intervals. The jejunal migrating motor complex continued to cycle after duodenectomy in all 4 dogs, but the mean period was shorter than before duodenectomy (83 min vs. 147 min, p less than 0.01). Duodenectomy abolished the cyclic variations of plasma motilin and pancreatic polypeptide and lowered the concentration of both peptides during all phases. This study suggests that the duodenum plays an important role in the initiation of the gastric migrating motor complex and in the coordination of interdigestive gastrointestinal motor activity, possibly by the release of motilin.

Animals↗

PubMed1981

Is dopamine an inhibitory modulator of gastrointestinal motility?

The effects of dopamine were studied on the isolated guinea-pig stomach preparation, including the duodenal bulb. Phasic activity: intra-arterially administered dopamine (0.25 mg/l) reduced phasic activity and blocked antro-duodenal coordination. The selective dopamine-antagonist, domperidone, increased phasic amplitude and improved antro-duodenal coordination. Tonic activity: gastric relaxation induced by equi-active concentrations of dopamine (0.25 mg/l, i.a.) and noradrenaline (0.04 mg/l, i.a.) could be antagonized by domperidone and prazosin; domperidone being more effective against dopamine and prazosin against noradrenaline. Our results support the hypothesis that dopamine acts as an inhibitory neuromodulator. The actions of dopamine in decreasing spontaneous activity and in inducing relaxation could set the stage for duodenal-gastric reflux.

Animals↗

PubMed1986

Achalasia and other diseases associated with disorders of gastrointestinal motility.

The aetiology of achalasia is unknown, but it has been suggested that it is congenital in origin and associated with such disorders as infantile pyloric stenosis or Hirschsprung's disease. Another reported association has been with Hodgkin's disease. A survey of 126 patients with achalasia, and their first degree relatives was undertaken to record the prevalence of infantile pyloric stenosis, Hirschsprung's disease and Hodgkin's disease. The prevalence of motor neurone disease and diabetes, which can be associated with motility disorders of the oesophagus, were also recorded as a measure of the efficiency of the questionnaire. None of the 126 patients with achalasia suffered from pyloric stenosis, Hirschsprung's disease, Hodgkin's lymphoma or motor neurone disease. There was no increased frequency of these disorders amongst first degree relatives. There appears to be no common aetiology for aganglionic bowel disease, and no obvious association between Hodgkin's disease and achalasia. Diabetes is seen with the expected frequency amongst patients with achalasia and their relatives, indicating the adequacy of the questionnaire.

Adolescent↗

PubMed1993

[Effect of cholecystokinin and its antagonists lorglumide, devazepide, and L-365,260 on gastrointestinal motility in rats].

Cholecystokinin (CCK) plays an important role in gallbladder contraction and gut motility. Sincalide (CCK-8) evoked guinea pig isolated ileum contraction at 10(-5)-10(-1) mumol.L-1 in a concentration-dependent manner, EC50 being 207 pmol.L-1. It delayed the gastric emptying as well. The rate of inhibition of gastric emptying was 71 +/- 12% at 100 micrograms.kg-1 by ip. Sincalide antagonists: lorglumide, devazepide, and L-365,260 antagonized the ileal smooth muscle response to sincalide in a concentration-dependent manner. Their pA2 were 7.30, 10.02, and 7.77, respectively. Lorglumide, devazepide, and L-365,260 inhibited the delaying of gastric emptying evoked by sincalide. The IC50 were 0.11, 0.0064, and 0.66 mg.kg-1, respectively.

Animals↗

PubMed1992

Non-invasive assessment of gastrointestinal motility disorders in diabetic patients with and without cardiovascular signs of autonomic neuropathy.

Twenty six patients with insulin dependent diabetes mellitus underwent a gastric emptying test, a gall bladder contraction test, an orocaecal transit study, and a colon transit test. Eleven patients had signs of cardiovascular autonomic neuropathy, 15 patients were without signs of cardiovascular autonomic neuropathy. Mean gastric clearance of radioopaque markers ingested with a meal averaged 29.5 (2.3) markers per six hours in subjects without cardiovascular autonomic neuropathy compared with 17.8 (2.3) markers per six hours in patients with cardiovascular autonomic neuropathy (p < 0.02). Gall bladder emptying in response to graded CCK8 stimulation was impaired in five of 11 patients with cardiovascular autonomic neuropathy, whereas it was normal in the patients without cardiovascular autonomic neuropathy (p < 0.01). Oral caecal transit times were not significantly different in the two patient groups, whereas colonic transit was slower in the patients with cardiovascular autonomic neuropathy compared with the group without cardiovascular autonomic neuropathy (p < 0.02). There was no correlation between disturbed gastric clearance, impaired gall bladder contraction, and prolonged colonic transit time in the patients with cardiovascular autonomic neuropathy nor was there a correlation between any disturbed motor function and age or duration of diabetes. It is concluded that autonomic neuropathy can affect motor functions throughout the gastro-intestinal tract. Any disturbed motor function in the gut could therefore be one of the numerous expressions of diabetic neuropathy affecting the cardiovascular, the endocrine or the gastrointestinal system.

Adult↗