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At least 163 records · Page 9Linked to original sources
PubMed1995

Effects of intravenous ketamine on gastrointestinal motility in the dog.

OBJECTIVE: The purpose of this trial was to clarify the effects of intravenous ketamine at anaesthetic and sub-anaesthetic dosages on gastrointestinal motility. DESIGN: 20 beagles (group 1: 3 mg/ketamine/kg/h, n = 10; group 2: 30 mg ketamine/kg/h, n = 10), were investigated. Gastric emptying (nuclide gastric emptying studies, liquid and semi-solid test meal), intestinal transit time (Hydrogen breath test with lactulose) and intestinal motor function (perfusion manometry with 8 measuring ports) were determined. As a control condition, the tests were performed on all dogs in the two groups during infusion of physiological saline solution. RESULTS: No significant differences in the motility patterns were present between 3 mg ketamine/kg/h and the control condition. For group 2, a moderately significant (p < 0.05) increase in the interdigestive motility index was observed for 30 mg ketamine/kg/h. However, this did not change the transit criteria. There was no significant difference between ketamine and control condition tests with regard to cycle and phase lengths or the propagation rate of the activity front. CONCLUSIONS: We conclude that ketamine provokes no basic changes in gastrointestinal motility, at either sub-anaesthetic doses. It can therefore be used to advantage in the continuous postoperative analgesia of intensive care patients, where repeated interventions are necessary and no cardiopulmonary contraindications are present.

Anesthetics, Dissociative↗
PubMed1996

Management of gastrointestinal motility disorders. A practical guide to drug selection and appropriate ancillary measures.

The focus of management of gastrointestinal motility disorders should be to improve survival and quality of life. Some motor disorders are annoying, but are compatible with virtually normal activity and carry no significant life risk. Conversely, other motor disorders are highly incapacitating and may shorten life expectancy because of complications and nutritional impairment. Management is based first on establishing the correct diagnosis and prognosis; secondly, on adjusting therapy to the severity of illness; and thirdly, on preventing significant complications. Simple recommendations on appropriate changes in lifestyle and reassurance may suffice in mild cases. Pharmacological therapy and, exceptionally, surgical or nutritional measures may be required in other patients. Generally, pharmacological agents should be directed towards correcting specific pathophysiological abnormalities, but this is not always possible. Symptomatic relief may be achieved on an empirical basis. Long term treatment may often require the combination of different therapeutic approaches either sequentially or simultaneously.

Adrenergic Agonists↗
PubMed1987

Influence of acoustic stress by noise on gastrointestinal motility in dogs.

The effects of acoustic stress (AS) on gastrointestinal motility and their prevention by previous treatment with naloxone, phentolamine, propranolol, muscimol, and diazepam were investigated in intact and vagotomized fasted dogs fitted with chronically implanted strain gauges on the antrum at 10 cm from pylorus and on the jejunum at 70 and 140 cm from the pylorus. These effects were compared to those produced by intracerebroventricular administration of ovine corticotropin releasing factor (oCRF). Beginning 40-50 min after the occurrence of a gastric migrating motor complex (MMC), a 1-hr hearing of prerecorded intense music through earpieces (less than 100 dB) delayed the occurrence of the next gastric MMC observed after 2.8 +/- 1.2 hr, while jejunal MMC were still present at a normal frequency. During AS, heart rate and plasma cortisol were significantly increased by 32.7 and 215%, respectively, 10-15 min after the beginning of hearing. The AS-induced lengthening of the gastric MMC cycle as well as cortisol increase were abolished after previous administration of diazepam (0.5 mg/kg intramuscular) or muscimol (10 micrograms/kg intravenous), while they were still present after naloxone (0.1 mg/kg intravenous), phentolamine (0.2 mg/kg intravenous), or propranolol (0.1 mg/kg intravenous). CRF administered intracerebroventricularly (100 ng/kg) also delayed the occurrence of gastric MMC without affecting jejunal motility, and this effect was not antagonized by previous treatment with diazepam or muscimol. Both the effects of AS and CRF were abolished after bilateral thoracic vagotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2006

Gastrointestinal motility: an academic and research perspective.

While, in the past, gastrointestinal motility may have been viewed as a narrow and restricted field, confined to the study of twitches in muscle baths and squiggles on smoke drums, it has, of late and belatedly, entered into the mainstream of gastroenterology and medicine. As a consequence, this field, now more correctly and appropriately described as neurogastroenterology, concerns itself with a vast spectrum of clinical disorders of varying pathophysiology, presentation and management. Never before has this area offered so many opportunities to the budding academician and researcher.

Biomedical Research↗
PubMed1993

Calcium-channel blockers and gastrointestinal motility: basic and clinical aspects.

Several calcium-channel blockers currently in use for the treatment of cardiovascular disorders have recently been tested for their effects on gastrointestinal motility. The rationale for this approach centers on the concept that calcium-channel blockers are at least as potent in inhibiting intestinal smooth muscle as in relaxing vascular smooth muscle. This review will give an outline of the most recent findings on the role of calcium and calcium channels in smooth muscle and neuronal function in the digestive system. It will also consider the mechanisms by which calcium-channel blockers may affect gastrointestinal motility and assess potential clinical applications in gastroenterology. The main goal for researchers in this field will be the development of gut-selective agents, with no cardiovascular side effects.

Animals↗
PubMed1993

[Results of animal experiments with videodensitometry in the assessment of gastrointestinal motility].

It is possible to register video-densitometrically the gastrointestinal motility visible in fluoroscopic image using a video-signal analyser. The influence of metoclopramide at the propulsive movement of the stomach wall of rats was checked in vivo. The propulsive gastric movement increased in case of small doses of metoclopramide, higher doses stopped the motility. The propulsive gastric movement is parallel to the evaluation of the stomach. Metoclopramide has only a mild influence on the contraction frequency. We found that videodensitometry is also a practical method for evaluation of local wall motility of an intestinal segment of a rabbit. The non-visible motion is recorded and evaluated by means of several physical parameters (frequency, moving velocity of waves). Videodensitometry does not supply information on the causes of motion; hence, a combination with other methods, i.e. the registration of the electromyogram (EMG), is useful. In this way the mechanical answer to EMG-changes is simple to quantify. The experiment with rabbits affords a proof regarding the practicability of the method for pharmaco-physiological investigations.

Animals↗
PubMedDate not supplied

Effect of ileojejunal transposition on gastrointestinal motility, gastric emptying, and small intestinal transit in dogs.

There is speculation that enteroglucagon and peptide YY are responsible for mediating the < > known as a suppressive reaction of upper gastrointestinal motility and transit that is induced by the infusion of nutrients into the ileum. We studied changes in motility and transit in dogs with ileojejunal transposition in which the distal ileum is exposed to undigested nutrients. Nine adult mongrel dogs were equipped with strain gauge force transducers placed on the gastric body, antrum, duodenum, and proximal jejunum. Measurements of gastrointestinal motility, gastric emptying, and plasma levels of total glucagon-like immunoreactivity, immunoreactive glucagon, and peptide YY were obtained both before and after either ileojejunal transposition (5 dogs) or sham operation (4 dogs). Postprandial contractions in the gastric antrum and gastric emptying were significantly inhibited after ileojejunal transposition. The inhibitory effect of ileojejunal transposition on antral motor activity was found to correlate with the rise in plasma total glucagon-like immunoreactivity and peptide YY concentrations. However, plasma glucagon levels were unaffected by ileojejunal transposition. These results suggest that hypersecretion of enteroglucagon and peptide YY induced by ileojejunal transposition inhibits postprandial gastric motor function.

Animals↗
PubMed1994

Erythromycin improves gastrointestinal motility in extremely low birthweight infants.

Erythromycin (EM) was administered to five extremely low birthweight infants (ELBWI) with delayed enteral feeding to evaluate the clinical effect on severely impaired gastrointestinal motility. Five patients studied responded well to EM administration without any adverse effects during the course. Four patients were given 15-30 mg/kg per day EM intravenously as a loading and thereafter 3-5 mg/kg per day as a maintenance dose. One patient responded well without loading. The infants could be fed enterally 4, 5, 6, 4 and 2 days after the initiation of EM administration, respectively. Erythromycin administration is a safe and useful way to facilitate gastrointestinal motility in ELBWI who require prolonged ventilator support with an increased risk for nutrient deprivation.

Erythromycin↗
PubMedDate not supplied

Effect of gastrointestinal motility and feeding tube site on aspiration risk in critically ill patients: a review.

OBJECTIVE: The purpose of this literature review is to examine the effect of the interaction between gastrointestinal motility and feeding site on the aspiration risk in critically ill, tube-fed patients. METHODS AND RESULTS: A single answer to the question of the preferred feeding site is not likely to be found because the degree of aspiration risk varies significantly according to individual variations in gastrointestinal motility and multiple pre-existing and treatment-related risk factors. However, regardless of the feeding site, it is ultimately regurgitated gastric contents that are aspirated into the lungs. For this reason, the clinical assessment of greatest interest is the evaluation of gastric emptying, usually monitored clinically by measuring gastric residual volumes. CONCLUSION: Current recommendations for monitoring residual volumes and preventing aspiration are provided.

Critical Care↗
PubMed1999

Changes in gastrointestinal motility influence the absorption of desmopressin.

OBJECTIVE: The antidiuretic effect of desmopressin is widely utilized in the treatment of neurogenic diabetes insipidus and nocturnal enuresis in children. The objective of the present study was to assess how changes in gastrointestinal motility, induced by erythromycin and loperamide, influence the pharmacokinetics of orally administered desmopressin. METHODS: This study was conducted using an open randomized, three-period, three-treatment design in 18 healthy subjects. On each study day a single oral dose of 400 microg desmopressin was administered in the morning. The desmopressin dose was either given alone (reference) or after pretreatment with either loperamide tablets (4 mg at -24, -12 h and -1 h) or erythromycin capsules (250 mg q.i.d, with the first dose in the morning 3 days before the study day and the last dose at -1 h). On each study day, blood was sampled up to 8 h after dosing for assessment of desmopressin concentration. RESULTS: Compared with administration of 400 microg of desmopressin alone, pretreatment with loperamide produced significantly (P < 0.05) altered pharmacokinetics of desmopressin as the endpoints; area under the curve up to infinity (AUC), area up to the last determinable plasma concentration (AUCt) and maximum plasma concentration (Cmax) increased 3.1-fold (95% CI 2.3-4.2), 3.2 (2.3-4.4) and 2.3 (1.6 3.2), respectively. Although the estimates were lower, pretreatment with erythromycin did not result in any significant changes in these endpoints. There were no significant changes observed between the three treatments regarding the terminal elimination half-life (t1/2). However, significant (P < 0.05) changes in the time to reach Cmax (tmax) values (median and range) were observed as, compared with administration of desmopressin alone (1.3 h and 0.5-4.0), it was longer after pretreatment with loperamide (2.0 h and 0.5-3.0) and shorter following pre-treatment with erythromycin (0.9 h and 0.5-1.3). CONCLUSION: Presumably due to slower gastrointestinal motility, pretreatment with loperamide significantly increases the gastrointestinal absorption of desmopressin. Except for a shortening of tmax pretreatment with erythromycin did not significantly influence absorption of the drug.

Adult↗
PubMed2000

Functions of peripheral 5-hydroxytryptamine receptors, especially 5-hydroxytryptamine4 receptor, in gastrointestinal motility.

The multiple 5-hydroxytryptamine (5-HT, serotonin) receptor subtypes are distinguished. In this article, we described mainly the 5-HT4 receptor of four subtypes of functional 5-HT receptors, 5-HT1, 5-HT2, 5-HT3, and 5-HT4, recognized in the gastrointestinal tract. In-vivo microdialysis experiments determined that activation of the 5-HT4 receptor stimulated intestinal motor activity associated with a local increase in acetylcholine (ACh) release from the intestinal cholinergic neurons in the whole body of dogs. The 5-HT4 receptor-mediated response of ACh release in the antral, corporal, and fundic strips isolated from guinea pig stomach corresponds to the presence of 5-HT4 receptor in the myenteric plexus. In-vitro receptor autoradiograms of the stomach and colon indicate that the distribution of 5-HT4 receptors in human tissues is similar to that in the guinea pig, although density of 5-HT4 receptors in the myenteric plexus of human tissues is lower than that in guinea pig tissues. The 5-HT4 receptors located in the myenteric plexus may participate in gastrointestinal motility, and thus the 5-HT4 agonists and antagonists may be available for treatment of dysfunction of gastrointestinal motility.

Animals↗
PubMed2006

Sexual differences of the inhibitory effect of ethanol on gastrointestinal motility: in vivo and in vitro studies.

Female brain is more sensitive to the acute exposure of ethanol. This study aimed to investigate the sexual difference of the ethanol-induced inhibition of gastrointestinal motility. Wistar rats were fasted and allowed drinking water only 12 - 18 h before the experiments. In the in vivo experiments, by using an oral radiochromium motility marker, the liquid gastric emptying and intestinal transit were [corrected] measured 30 min after ethanol treatment. In the in vitro study, strips of stomach and duodenum smooth muscle were suspended in organ baths containing Krebs solution, and their isometric contractions were also examined. Systemic administration of ethanol (2 g/kg, i.p.) significantly inhibited the gastric emptying and intestinal transit, and the effect on female rats turned out to be greater than that on the male rats (P < 0.05). In an in vitro study, ethanol (0.38 x 10(-3) M - 1.34 x 10(-3) M) inhibited the motility of gastric antrum and duodenum in rats of both sexes, but there was no sexual difference in the inhibitory effect of ethanol on muscle strips. We concluded that sexual difference of the ethanol-induced inhibition of gastrointestinal motility was not resulted from the smooth muscle itself.

Animals↗
PubMed1995

Hyperinsulinaemia impairs gastrointestinal motility and slows carbohydrate absorption.

Experimental euglycaemic hyperinsulinaemia (insulin levels 46 +/- 4 mU/l) impaired the post-absorptive gastrointestinal motility in healthy individuals; the effect being particularly pronounced in the upper gastrointestinal tract (stomach and proximal duodenum). The postprandial gastric emptying, measured with a standardized 99mTc labelled meal, was also significantly delayed (t50 increased by 38% or 32 min). This was combined with a slower carbohydrate absorption (delay in peak blood glucose level about 40 min). Furthermore, during experimental hyperinsulinaemia higher blood glucose levels were seen at 120 min than at 60 min after food ingestion. This was not seen in any subject in the control study where only 0.9% NaCl was infused. Blood levels of the motility-stimulating hormone, motilin, were significantly lower during experimental hyperinsulinaemia. Thus, experimental hyperinsulinaemia impairs the gastrointestinal motility in both the postabsorptive and postprandial states. This effect is combined with a delayed carbohydrate absorption. Hyperinsulinaemia per se may thus lead to alterations in carbohydrate absorption and can also contribute to the gastrointestinal disturbances in diabetes.

Acute Disease↗
PubMed1986

Effect of bethanechol and metoclopramide on upper gastrointestinal motility in the kitten.

Gastroesophageal reflux (GER) during infancy is a disorder of unknown etiology which may be associated with abnormalities of upper gastrointestinal motor function. Bethanechol, a muscarinic agonist, and metoclopramide, a dopamine antagonist, have been utilized as pharmacologic agents in an attempt to improve upper gastrointestinal motility in this disorder. We have studied the effect of these agents on upper gastrointestinal motility in an infant model, the kitten. Bethanechol is found to greatly increase lower esophageal sphincter (LES) pressure and have no effect on esophageal peristaltic amplitude or gastric emptying of a liquid meal. Metoclopramide causes a small and nonsignificant increase in LES pressure, has no effect on esophageal peristalsis, and increases the rate of gastric emptying of a liquid meal. These results suggest that these two agents may have specific actions on the infant's upper gastrointestinal tract.

Animals↗
PubMed1987

Modulation of human upper gastrointestinal motility by rectal distension.

The effects of rectal distension on upper gastrointestinal motility were investigated in six healthy subjects. On a control day, gastric and duodenal motor activity was recorded for nine hours of fasting and for four hours after a meal, duodeno-caecal transit being assessed in both interdigestive and digestive states. Motor activity and transit were also measured on a test day during which the rectum was distended for one hour during fasting and for one hour postprandially. Control and test days were randomised. During fasting, rectal distension increased the incidence of migrating motor complexes (0.8 +/- 0.3 v 0.5 +/- 0.2 h; p less than 0.01) and reduced the duodenal phase 2 motility index to 66 +/- 45% of that observed on the control day (p less than 0.01). Further, duodeno-caecal transit time was increased by rectal distension (99 +/- 30 v 71 +/- 35 min; p less than 0.05). Postprandially, the period of rectal distension was marked by a reduction in the duodenal motility index to 24 +/- 13% of that observed during the comparable period on the control day (p less than 0.001) and a concomitant increase in duodeno-caecal transit time (113 +/- 22 v 80 +/- 17 min; p less than 0.01). We conclude that upper gastrointestinal motor activity, the effector of luminal transit, may be profoundly influenced by stimulation of distal afferents.

Action Potentials↗
PubMed1988

Gastrointestinal motility disorders in children.

The present state of knowledge regarding human gastrointestinal motility is summarized in this article. Areas that are of particular interest in childhood are highlighted. The relationship of this knowledge to disease states is discussed and areas where it might practically be applied indicated.

Child↗