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PubMed2003

Postprandial symptoms in dysmotility-like functional dyspepsia are not related to disturbances of gastric myoelectrical activity.

Gastric dysrhythmias, such as tachy- or bradygastria, have been reported in patients with functional dyspepsia (FD), but their role in symptom production is uncertain. It is also not known whether gastric dysrhythmias in these patients can be elicited by physiological gastric distension with a meal. We investigated the relationships between symptoms after ingestion of different volumes of water following a test meal and gastric dysrhythmias in FD patients. Fourteen patients with dysmotility-like FD and 13 healthy volunteers underwent paired electrogastrography (EGG) studies. Fasted subjects ingested 150 ml of yoghurt with either 150 ml (low volume) or 300 ml (high volume) water in random order. Fasting and fed EGGs with monitoring of symptoms were performed in both studies. Ten FD patients (71.4%) reported upper abdominal discomfort and bloating after the low volume meal, but only one (7.1%) presented an abnormal EGG (dominant frequency in the 2-4-cpm range: 58%). Following the high volume meal, 7 patients (50%) had symptoms, but none had EGG abnormalities. No significant differences were found between FD patients and controls for any of the EGG variables, in any test. In FD patients with postprandial symptoms, the percentage of the EGG dominant frequency in the normal range (median, 84.6%; range, 76.0-100.0%) was similar (P>0.20) to that in those without symptoms (88.5%; 75.0-100.0%). We conclude that disturbances of gastric myoelectrical activity are unlikely to play a role in the origin of postprandial upper abdominal discomfort and bloating in dysmotility-like FD.

Adult↗
PubMed2003

[Antroduodenal motility and pH changes after partial gastrectomy including the pacemaker region of the dog's stomach].

BACKGROUND: Functional alterations of antroduodenal motility are not well defined at present. The gastric pacemaker is located at the greater curvature, next to the fundus. PURPOSE: The aim was to evaluate the influence of the gastric pacemaker on the gastroduodenal motility in dogs. METHODS: The study was designed in three steps and performed with 20 dogs: first, construction of a cervical esophagostomy to measure the antroduodenal motility and gastric pH-metry as validation step. The manometry was performed by means of a six point electronic manometry probe and both manometry and pH-metry were recorded during 4 hours. Second, the stomach's pacemaker region and gastric reservoir were resected by videolaparoscopy. Third, the antroduodenal motility and gastric pH-metry were measured again. RESULTS: In the validation step, there was established a typical dogs' antroduodenal motility pattern, with a three-shaped interdigestive motility complex (IMC) (phases 1 to 3); the gastric pH-metry showed a baseline at pH 1,15. After partial gastric resection, overall there was an increase in contractions' frequency, an increase in phase 2 and a decrease in phase 3 participation on the IMC's. Regarding the gastric pH measurements, there was an increase in pH intervals 0-1 and 1-2 and a decrease in pH intervals 6-7; overall, there was a decrease in the stomach's pH and a decrease in the prandial time. CONCLUSION: The resection of the stomach's pacemaker region and gastric reservoir correlated with alterations in antroduodenal motility, maintaining however the typical IMC pattern.

Animals↗
PubMed2001

Myoelectric response of the small intestine to the orad presence of the tapeworm Hymenolepis diminuta.

During its 24-hr migratory cycle in the small intestine, Hymenolepis diminuta is located in the orad part of the small intestine during the early morning hours and then in the caudad part of the small intestine during the late afternoon and early evening. During the later period, tapeworm-induced alterations of interdigestive myoelectric activity, a correlate of smooth muscle contraction or intestinal motility, are most intense in the ileal region. The hypothesis tested was that the tapeworm-induced changes in intestinal motility are local responses of the intestine responding to the close proximity of the lumenally positioned tapeworm and to the nutritional state of the host. The small intestine was monitored before and for 20 days after infection using electrodes implanted on the serosa of the small intestine. Myoelectric recordings were analyzed for the frequency of the normal patterns of interdigestive myoelectric spiking patterns and the altered myoelectric spiking related to tapeworm infection. During the morning hours, when the tapeworms are situated in the orad small intestine, no changes were observed during the normal myoelectric pattern of the digestive phase in any region of the intestine. When examined after the conversion of the digestive to interdigestive phase of motility, only on day 10 postinfection was the interdigestive phase significantly altered. It was concluded that the presence of the tapeworm in the orad small intestine during the satiety stage of the rat causes no changes in the electric events of the small intestine, with the exception of day 10 postinfection. Because tapeworms in the orad small intestine do not induce the tapeworm-altered myoelectric activity observed in the afternoon and evening with caudally positioned tapeworms, tapeworm-altered motility is not simply a response of the small intestine to the local presence of the tapeworm.

Animals↗
PubMed2004

Gastric dysmotility associated with accumulation of mitochondrial A3243G mutation in the stomach.

OBJECTIVE: We analyzed the accumulation of a mitochondrial A-to-G mutation at nucleotide position 3243 (A3243G) in the stomach and gastric motility in patients with gastric symptoms, post-prandial nausea/vomiting and epigastralgia. METHODS: Detection and quantification of A3243G mutation in mtDNA in the gastric mucosa, oral mucosa, leukocyte, and skeletal muscle were performed. Gastric motility was evaluated by gastric myoelectrical activity on electrogastrography (EGG), and gastric emptying was evaluated by measurement of plasma paracetamol concentration before and after meals. PATIENTS OR MATERIALS: Four patients with A3243G mutation in the leukocyte mtDNA and gastric symptoms were examined. RESULTS: The A3243G mutation was detected at higher percentages in the gastric body (69-94% for mutation; mean, 83%) than in the angle portion (37-82%; mean, 52%), the antrum (40-84%; mean, 57%) or leukocytes (28-52%; mean, 39%), and at slightly higher percentages than in the skeletal muscles (45-87%; mean, 70%) or oral mucosae (52-86%; mean, 69%) in the four patients examined. Abnormal EGGs were observed in the three patients examined. The pre-prandial myoelectrical activities were low in these patients (49% in patient 1, 54% in patient 2, 63% in patient 3; normal >70%). The plasma concentrations of paracetamol were low (3.6 microg/ml in patient 1, 2.4 microg/ml in patient 2, <2.0 microg/ml in patient 3; normal, 7-12 microg/ml). CONCLUSION: Accumulation of mitochondrial A3243G mutation in the stomach is a contributory factor in gastric dysmotility and gastric symptoms in patients with the mutation in their leukocytes.

Adult↗
PubMed1997

Gastric myoelectrical activity in patients with diabetes. Role of glucose control and autonomic nerve function.

OBJECTIVE: Gastric myoelectrical activity was studied in diabetic patients using electrogastrography (EGG) to elucidate the relationship between glucose control, diabetic autonomic neuropathy (AN), and gastrointestinal motility. RESEARCH DESIGN AND METHODS: Cutaneous EGG was recorded during 1 h of fasting and 1 h after the ingestion of a standard meal in 57 diabetic patients and 10 healthy subjects. EGG was measured in 12 diabetic patients after glycemic control for 4 weeks. Diabetic patients were also studied with respect to the presence of gastrointestinal symptoms and AN. RESULTS: The percentage of dominant electrical frequency (DF) in normal range (the percentage ratio between the power at 2.4-3.6 cycles/min [cpm] and at 1-10 cpm) was significantly lower in patients with AN than in either the control subjects or the patients without AN (P < 0.01). The dominant frequency instability coefficient (DFIC) was significantly higher in patients with and without AN than in the control subjects (P < 0.01). The postprandial-to-fasting power ratio (PR) was the lowest in patients with AN (P < 0.01). Multiple regression analysis revealed that HbA1c levels were independently associated with the DFIC (R2 = 0.099, P = 0.0170) and that AN and HbA1c levels were independently associated with the PR (R2 = 0.378, P < 0.0001) in diabetic patients. The percentage of normal DF increased and the DFIC decreased significantly after glycemic control in 12 diabetic patients (P = 0.0409; P = 0.0096, respectively). CONCLUSIONS: There appears to be an association between improvement in gastric myoelectrical activity and autonomic nerve function. Abnormalities of gastric myoelectrical activity may be partly ameliorated via the improvement of autonomic nerve function, which accompanies glycemic control.

Adult↗
PubMed2000

Prokinetic effects of erythromycin on the ileum, cecum, and pelvic flexure of horses during the postoperative period.

OBJECTIVE: To evaluate the effect of erythromycin on motility of the ileum, cecum, and pelvic flexure of horses during the postoperative and post-recovery periods. ANIMALS: 8 healthy adult horses. PROCEDURE: Horses were anesthetized and bipolar electrodes were implanted in smooth muscle of the ileum, cecum, and pelvic flexure. Approximately 4, 16, and 24 hours (postoperative recording sessions) and at least 8 days (post-recovery recording session) after surgery, myoelectric activity was recorded before and after administration of erythromycin (0.5 mg/kg). RESULTS: Following erythromycin administration, myoelectric activity was increased in the ileum during all postoperative recording sessions but not during the post-recovery recording session. Myoelectric activity was increased in the cecum following erythromycin administration only during the post-recovery recording session. Myoelectric activity was increased in the pelvic flexure following erythromycin administration during all recording sessions. During several recording sessions, there were short periods during which myoelectric activity was significantly decreased following erythromycin administration. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that erythromycin has an effect on myoelectric activity of the ileum, cecum, and pelvic flexure in horses; however, prokinetic effects of erythromycin administered during the postoperative period were not always the same as effects obtained when the drug was administered after horses had recovered from the effects of surgical implantation of recording devices. Therefore, caution must be exercised when extrapolating results of prokinetic studies in healthy animals to animals with abnormal gastrointestinal tract motility.

Animals↗
PubMed2004

Myoelectric activity in the intestines of healthy dairy cows during the recovery period after implantation of permanent electrodes.

OBJECTIVE: To describe myoelectric patterns in the intestines of cows after electrode implantation. ANIMALS: 7 lactating Simmental-Red Holstein cows. PROCEDURE: Cows were implanted with 7 pairs of bipolar silver electrodes (1 each in the ileum, cecum, and proximal loop of the ascending colon (PLAC) and 4 in the spiral colon). Myoelectric activity was monitored during 10 periods within the first 3 weeks after surgery. Recordings from the first 2 weeks were compared with recordings from the third week, which was considered a steady-state condition. RESULTS: Significant changes over time were detected for 18 of 57 variables, including 3 variables describing myoelectric activity of the ileum, 6 variables of the cecum, 6 variables of the PLAC, and 3 variables of the spiral colon. Compared with values for the steady-state condition, 16 variables differed significantly for the 14-day period after surgery (7 variables until day 11, 2 variables until day 8, 4 variables until day 5, 1 variable until day 3, and 2 variables until day 2 after electrode implantation). None of the variables had significant changes that lasted only 1 day after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Significant changes were observed for several variables of myoelectric activity in all intestinal segments until as late as 11 days after electrode implantation, whereas a steady-state condition was reached 14 days after surgery. Effects of drugs, manipulations, or nutrition regimens on myoelectric activity of the bovine digestive tract should be evaluated no sooner than 2 weeks after electrode implantation.

Animals↗
PubMed1996

Transcutaneous electrosigmoidography. Study of the myoelectric activity of sigmoid colon by surface electrodes.

The purpose of this study was to determine the feasibilty of performing transcutaneous electrosigmoidography (TC-ESG). The study involved 19 healthy volunteers (11 men, 8 women; mean age 38.2 +/- 14.8 years). To validate the results of TC-ESG, the latter was performed simultaneously with intra-sigmoid ESG. TC-ESG was done also in five patients who underwent sigmoidectomy. The optimal position of the electrodes was determined after several trials. Two electrodes (Beckman) were applied, each 2-3 cm away from the middle of a line drawn from the umbilicus to the symphysis pubis. A third electrode was placed just above the symphysis pubis. A reference electrode was applied to one of the lower limbs. For intra-sigmoid IS-ESG, two silver-silver chloride electrodes were introduced from the anal orifice into the sigmoid colon and were attached to the mucosa by suction. Pacesetter potentials (PPs) were recorded as regular negative deflections. They had constant amplitude, frequency and velocity when recordings were obtained in the same subject. The PPs registered transcutaneously had the same amplitude, frequency and velocity as those recorded intrasigmoidally. Action potentials could be registered only intrasigmoidally and not transcutaneously. No electric waves could be recorded by TC-ESG in 5 patients who had undergone sigmoidectomy. In conclusion, TC-ESG is a simple, non-invasive and non-radiologic technique that can substitute intra-sigmoid ESG and potentially can be used in the diagnosis of various pathologic conditions of sigmoid colon.

Action Potentials↗
PubMed1990

Where do we stand on gastric motility?

This review deals with several aspects of gastrointestinal motility. It attempts to relate basic knowledge to clinically relevant issues. The review is organized around specific contractile patterns and tasks in the gastrointestinal region that are grouped into three broad categories: tonic contractility of the stomach, antral phasic contractility, and resistance of the gastric outlet. There is also a section dealing with the evaluation of gastric motor function for diagnostic purposes describing the technologic means for investigating motility disorders in patients presenting with different clinical syndromes. In this section there is also reference to the criteria to be used in interpretation of the results and practical advice on the use of each test. Finally, the review deals with the issue of treatment of gastric motor disorders, comprising both dietary and pharmacologic approaches.

Gastric Emptying↗
PubMed1991

Free radicals scavengers attenuate platelet-activating factor (PAF)- and endotoxin-induced intestinal myoelectric disturbances in rats.

Pretreatment with radical scavengers significantly reduced the intestinal myoelectric disturbances following either E. coli endotoxin or platelet-activating factor (PAF) injection in the rat indicating that free radicals might be involved in the intestinal motor alterations observed in endotoxin shock and that PAF acts partially via free radical production. Moreover, dimethylsulfoxide (DMSO) was found to be more effective in inhibiting the endoxotin-induced intestinal motor alterations, than superoxide dismutase (SOD) and allopurinol. BN 52021, a specific PAF antagonist, was able to reduce the effects of endotoxin on intestinal motility. However, when BN 52021 was combined with free radical scavengers, no additive effect was observed. It is concluded that free radicals involved in endotoxin-induced intestinal motility alterations are at least in part produced in response to PAF.

Animals↗
PubMed2005

Impaired gastric myoelectricity in patients with chronic pancreatitis: role of maldigestion.

AIM: To investigate whether gastric myoelectrical activity was impaired in patients with chronic pancreatitis (CP) and to explore the role of pancreatic enzyme in regulating gastric myoelectrical activity. METHODS: Twenty CP patients and 20 controls participated in the study. Gastric myoelectrical activity was recorded by a homemade electrogastrography (EGG) device. Two experiments were carried out. In experiment one, EGG was recorded in both controls and CP patients. While in experiment two, either pancreatic enzymes or placebo was given together with test meals. Spectral analysis was used to generate various EGG parameters. RESULTS: The control subjects, but not the CP patients, showed typically increased postprandial dominant frequency. The postprandial dominant power (DP) increment (2.24+/-1.13 vs 5.35+/-0.96 dB, P = 0.04) and the percentage of normal 2-4 cpm slow waves (63.0+/-3.8% vs 77.4 +/-3.1%, P<0.05) were lower in CP patients when compared with the control. In the 20 CP patients, the DP increment (4.76+/-1.02 vs 2.53+/-1.20 dB, P<0.05) and the postprandial percentage of normal 2-4 cpm (74.4+/-2.8% vs 64.8+/-5.7%, P<0.05) were significantly higher with pancreatic enzyme replacement than the placebo. CONCLUSION: CP patients have an abnormal postprandial stomach myoelectricity showing poor response in dominant frequency/power and regularity, whereas these abnormalities are corrected after pancreatic enzyme replacement. Maldigestion is likely to be the factor leading to abnormal postprandial gastric myoelectricity of CP patients.

Adult↗
PubMed2006

Effect of electroacupuncture at Sibai on the gastric myoelectric activities of denervated rats.

AIM: To explore the mechanism of the exciting effects of electro-acupuncture (EA) at Sibai on the gastric myoelectric activities. METHODS: A total of 32 rats were randomly divided into four groups. Through intraperitoneal injection with atropine (the anti-cholinergic agent by blockade of muscarinic receptors), hexamethonium (automatic nerve ganglion-blocking agent) and reserpine (anti-adrenergic agent by depleting the adrenergic nerve terminal of its norepinephrine store), effects of EA at Sibai on the gastric myoelectric activities of the denervated rats were observed. RESULTS: After intraperitoneal injection of atropine and hexamethonium, the average amplitude and ratio of period to time in the phase of high activity of gastric myoelectric slow wave, and the average numbers of the peaks of gastric myoelectric fast wave were significantly decreased (P<0.01, P<0.05, P<0.01), while after intraperitoneal injection of reserpine, the aforementioned three parameters were increased (P<0.01, P<0.05, P<0.01). EA at Sibai point partially relieved the inhibitory effect of atropine and hexamethonium on the gastric myoelectric activities in the rats (P<0.05 or P>0.05). CONCLUSION: Cholinergic and adrenergic nervous systems and autonomic nerve ganglion participate in the peripheral passage of the controlling effects of EA at Foot Yangming Channel on gastrointestinal tract.

Acupuncture Points↗
PubMed2006

Postprandial transduodenal bolus transport is regulated by complex peristaltic sequence.

AIM: To study the relationship between the patterns of postprandial peristalsis and transduodenal bolus transport in healthy subjects. METHODS: Synchronous recording of chyme transport and peristaltic activity was performed during the fasting state and after administration of a test meal using a special catheter device with cascade configuration of impedance electrodes and solid-state pressure transducers. The catheter was placed into the duodenum, where the first channel was located in the first part of the duodenum and the last channel at the duodenojejunal junction. After identification of previously defined chyme transport patterns the associated peristaltic patterns were analyzed. RESULTS: The interdigestive phase 3 complex was reliably recorded with both techniques. Of 497 analyzed impedance bolus transport events, 110 (22%) were short-spanned propulsive, 307 (62%) long-spanned propulsive, 70 (14%) complex propulsive, and 10 (2%) retrograde transport. Short-spanned chyme transports were predominantly associated with stationary or propagated contractions propagated over short distance. Long-spanned and complex chyme transports were predominantly associated with propulsive peristaltic patterns, which were frequently complex and comprised multiple contractions. Propagated double wave contraction, propagated contraction with a clustered contraction, and propagated cluster of contractions have been identified to be an integralted part of a peristaltic sequence in human duodenum. CONCLUSION: Combined impedancometry and manometry improves the analysis of the peristaltic patterns that are associated with postprandial transduodenal chyme transport. Postprandial transduodenal bolus transport is regulated by propulsive peristaltic patterns, which are frequently complex but well organized. This finding should be taken into consideration in the analysis of intestinal motility studies.

Adult↗
PubMed1999

Intestinal prokinesia by two esters of 4-amino-5-chloro-2- methoxybenzoic acid: involvement of 5-hydroxytryptamine-4 receptors and dissociation from cardiac effects in vivo.

In five fasting, conscious dogs, we compared the prokinetic action of two selective 5-hydroxytryptamine-4 (5-HT4) receptor agonists with low affinity for 5-HT3 receptors ML10302 (2-piperidinoethyl 4-amino-5-chloro-2-methoxybenzoate) and SR59768 (2-[(3S)-3-hydroxypiperidino]ethyl 4-amino-5-chloro-2-methoxybenzoate) in the duodenum and jejunum, using cisapride as a reference compound. Heart rate and rate-corrected QT (QTc) also were monitored to assess whether or not the cardiac effects of cisapride are shared by other 5-HT4 receptor agonists. Both ML10302 and SR59768 dose-dependently stimulated spike activity in the duodenum with similar potencies (dose range, 3-300 nmol/kg i.v.; ED50 values: 24 and 23 nmol/kg i.v., respectively), mimicking the effect of cisapride (30-3000 nmol/kg i.v.). The maximal effect was achieved with the dose of 100 nmol/kg i.v. for both compounds. Similar findings were obtained in the jejunum. Atropine and GR125487 (1-[2-[(methylsulfonyl)amino]ethyl]-4-piperidinyl-methyl 5-fluoro-2-methoxy-1H-indole-3-carboxylate, selective 5-HT4 receptor antagonist), at doses having no effect per se, antagonized intestinal prokinesia by maximal doses of ML10302 and SR59768. Neither ML10302 nor SR59768 had any effect on heart rate or QTc at any of the doses tested, whereas cisapride, at the highest dose (3000 nmol/kg), induced tachycardia and lengthened the QTC (p <.01). In conclusion, ML10302 and SR59768 share with cisapride a similar prokinetic action in the canine duodenum and jejunum in vivo. This effect is mediated by pathways involving activation of 5-HT4 and muscarinic receptors. Unlike cisapride, which induces tachycardia and prolongs the QTc by a mechanism probably unrelated to 5-HT4 receptor activation, ML10302 and SR59768 are devoid of cardiac effects in this model.

Aminobenzoates↗
PubMed1998

Myoelectric bowel activity in ischemia/reperfusion damage. Role of sensory neurons.

The present knowledge indicates that afferent sensory neurons (C-fibres) play an important role in the relationship between intestinal myoelectric activity (IMA) and blood flow (LDBF). The aim of this study was to evaluate the role of C-fibers in myoelectric activity of small intestine during its ischemia and reperfusion. A neurotoxin-capsaicin (CAP) was used to induce functional ablation of afferent sensory neurons. Experiments were performed on 6 groups of anesthetized rats. In the I, II, III group of rats IMA and LDBF were recorded during 100% ischemia induced by AMA 15, 30 and 60 min total occlusion and during 60 min reperfusion period. In group V and VI, IMA and LDBF were registered after intrajejunal placement of 1% CAP. In group IV we measured effects of intraluminal instillation of CAP alone. Intraluminal placement of CAP induced an early increase in slow wave amplitude SWA and slow wave frequency SWF by 35+/-11% and 19+/-10% (p<0.05) with the subsequent decrease in both by 25+/-6 and 24+/-8% (p<0.05) respectively. Short 15 min lasting ischemia induced by 100% occlusion of AMA evoked only a slight increase of SWA. During reperfusion period SWA and SWF returned to the baseline values after 15 min. Total 30 min occlusion decreased SWA and SWF by 25+/-9 and 24+/-6% (p<0.05) respectively. During reperfusion period recovery of IMA parameters to preocclusion values were slower. Intestinal hyperemia was smaller than in previous group. After 60 min lasting intestinal ischemia SWA and SWF were decreased by 58+/-7 and 40+/-6% (p<0.01) respectively. There was no return of IMA parameters to control values. These data demonstrated that intestinal ischemia induces typical changes in the bowel myoelectric activity. These changes possess their own electrical characteristics which can be used in clinical practice for evaluation of the degree ischemically-induced intestinal injury. Capsaicin pretreatment significantly decreased SWA and SWF and LDBF in comparison with those observed in group II and III during 30 and 60 min occlusion and reperfusion period. We conclude that afferent neurons C activated during mesenteric ischemia/reperfusion play an important role in protecting ischemic bowel viability.

Animals↗
PubMed1999

[Effectiveness of pinaverium bromide therapy on colonic motility disorders in irritable bowel syndrome].

The special patterns of the slow wave activity in irrittable bowel syndrome by means of surface electromyography were examined and the effect of pinaverium bromide on the symptoms and on the colonic motility in this disease was estimated. Twenty two patients with irritable bowel syndrome and 7 healthy controls were selected to the study. The clinical symptoms were abdominal pain and bloating in all patients, constipation in 9, and diarrhoea in 6 cases. Surface electromyography was carried out before and on the 14th day of the treatment with pinaverium bromide (50 mg t. i. d). The colonic motility was analysed in a 2 hour fasting and a 2 hour postprandial period following a standard (800 kCal) meal. The slow wave frequency of 0.01-0.04 Hz were selected and analysed. The mean frequency of activity peaks (n/10 min) and power-index (area under curve, microV 10 min) were measured. For statistical analysis Student's t-test was applied. Electromyogram of patients with irritable bowel syndrome showed a significant increase of the measured colonic motility parameters both in fasting and postprandial states. Fourteen days of pinaverium bromide treatment was able to significantly reduce the intensity of the colonic motor activity. Administration of pinaverium bromide completely released in 6 and significantly improved the abdominal pain in other 12 patients, while the bloating disappeared in 12 and was significantly improved in 5 from 22 patients. Pinaverium bromide was able to normalise the stool frequency: the weekly number of stools was decreased from 16 to 7 in the patients complaining diarrhoea ant it was increased from 2 to 6 in the patients with constipation.

Calcium Channel Blockers↗