Biomedical subjects

A A Masclee

Publications and source records attributed to A A Masclee.

At least 19 recordsLinked to original sources

PubMed2004

Faecal elastase-I: helpful in analysing steatorrhoea?

BACKGROUND: The faecal elastase-1 test (FE-1) is considered easy to perform and sensitive to detect severe and moderate exocrine pancreatic insufficiency. However, little information is available on the specificity of this test in the analysis of steatorrhoea. Our aim was to evaluate the clinical value of FE-1 in the analysis of patients sent in for faecal fat determination. METHODS: Stool samples were collected over 24 hours in 40 healthy controls and 119 patients: 58 patients with chronic pancreatitis and 61 nonpancreatic disease patients with chronic diarrhoea. Faecal fat excretion was determined and FE-1 was measured using a commercially available ELISA kit, which employs two monoclonal antibodies to bind to two distinct epitopes of human pancreatic elastase-1. RESULTS: Faecal elastase-1 test shows good reproducibility. The test lacks sensitivity in detecting exocrine pancreatic insufficiency and chronic pancreatitis (68 and 59%, respectively). However, it is specific with respect to differentiating pancreatic from nonpancreatic causes in patients with steatorrhoea. CONCLUSION: FE-1 lacks sensitivity to detect chronic pancreatitis. It can serve as a simple, noninvasive method to determine the aetiology of steatorrhoea.

Case-Control Studies↗

PubMed2001

Effect of intraduodenal and intravenous amino acids on proximal gastric motor function in man.

The present study was performed to investigate the effect of amino acids during the intestinal and postabsorptive phase of digestion on proximal gastric motor function measured with an electronic barostat. Eight healthy volunteers participated in three experiments performed during continuous infusion of: (1) intravenous and intraduodenal saline, (2) intraduodenal amino acids, and (3) intravenous amino acids. Both intraduodenal and intravenous amino acids induced gastric relaxation and increased gastric compliance. Only during intraduodenal amino acids did plasma CCK levels increase significantly. Correlation between intragastric volume measurements (with pressure set at MDP + 2 mm Hg) and plasma CCK levels was 0.90 (P < 0.001) during the early intestinal phase. Relaxation of the proximal stomach is related to plasma CCK in the early intestinal phase, whereas in the postabsorptive phase of amino acids other mechanisms play a role in proximal gastric relaxation.

Adult↗

PubMed2001

Does Helicobacter pylori gastritis affect motor function of proximal stomach in dyspeptic patients?

The role of Helicobacter pylori infection in proximal gastric motor function and its relation to symptoms in patients with functional dyspepsia is still unclear. We prospectively studied 26 patients with dyspepsia, no structural abnormalities found during endoscopy and biopsy-proven Helicobacter pylori-positive gastritis before and three months after Helicobacter pylori treatment. We used an 11-item score list to evaluate symptoms, gastric biopsies for histology, and a gastric barostat (isobaric inflation-deflation) for proximal gastric motility. Minimal distending pressure (MDP), mean gastric volume at operating pressure, AUC of inflation-deflation cycles, and hysteresis (difference in AUC during inflation and AUC during deflation) were calculated. After three months, Helicobacter pylori was eradicated in 96% of patients. MDP, mean gastric volume at operating pressure, gastric compliance, and hysteresis did not change significantly. Aggregate symptom score as well as histology scores in antrum and corpus decreased significantly. Reduction in postprandial pain correlated with a change in hysteresis (r = 0.567, P < 0.01), but other symptoms did not. Reduction of corpus inflammatory activity correlated with changes in hysteresis (r = 0.604, p < 0.005), suggesting that the stomach attains it original shape faster when inflammation is reduced. These observations suggest that inflammatory changes or release of inflammatory substances associated with Helicobacter pylori infection may influence proximal gastric motor characteristics.

Adult↗

PubMed2001

Comparison of ileoanal pouch and rectal function measured by barostat.

The aim of this study was to compare pouch and rectal sensory and motor characteristics and to assess the influence of a meal on pouch tone and motility. Fifteen patients with an ileoanal J-pouch, with adequate pouch function and 12 healthy controls were studied. Visceral compliance was assessed using an electronic barostat by a pressure distension procedure, during which also sensitivity was scored by visual analog scales (VAS). The response to a meal was assessed during set pressure. Pouch and rectal compliance were not significantly different (9.3+/-0.7 vs 10.6+/-1.1 ml/mm Hg). VAS score for urge at 28 mm Hg was reduced in patients: 2.4+/-0.5 cm vs 4.7+/-0.9 cm in controls (P < 0.05). The postprandial decrease in intra-bag volume was more pronounced in patients (44+/-11%) than in controls (9+/-6%, P < 0.01). Postprandial phasic contractions were also more pronounced in patients. In conclusion, compliance is not significantly different between ileoanal pouch and rectum; differences in sensitivity reach significance only at high pressure. Significant differences were especially observed in the postprandial state with an increase in tone and frequency of phasic contractions in pouch patients.

Adult↗

PubMed2001

Prospective study of the effect of laparoscopic Nissen fundoplication on reflux mechanisms.

BACKGROUND: Laparoscopic Nissen fundoplication effectively reduces acid reflux and reflux symptoms. Little is known about the effect on reflux mechanisms, especially on transient lower oesophageal sphincter relaxations (TLOSRs). METHODS: Twenty-seven patients were studied prospectively before and after laparoscopic Nissen fundoplication, by simultaneous recording of pH and lower oesophageal sphincter (LOS) characteristics using sleeve manometry. In all of the 27 patients the operation was judged successful, based on major improvement or resolution of reflux symptoms and acid reflux. Vagus nerve integrity was studied indirectly by the secretion of pancreatic polypeptide (PP) in response to insulin-induced hypoglycaemia. RESULTS: After fundoplication basal LOS pressure increased significantly from mean(s.e.m.) 13(1) to 22(1) mmHg (P < 0.001). Laparoscopic Nissen fundoplication significantly decreased the frequency of TLOSR in the fasting period from mean(s.e.m.) 2.5(0.5) to 0.6(0.2) per h, and in the postprandial period from 4.0(0.4) to 1.3(0.3) per h (P < 0.01). The percentage of TLOSRs associated with reflux also decreased significantly from 24(10) to 0(0) per cent in the fasting period and from 42(6) to 12(6) per cent in the postprandial period, before and after fundoplication respectively (P < 0.01). After operation the PP response was abnormal in three patients, pointing to vagus nerve dysfunction. Postoperative TLOSR frequency and LOS pressure were no different between patients with and without vagus nerve dysfunction. CONCLUSION: Laparoscopic Nissen fundoplication significantly increased fasting and postprandial LOS pressure and significantly decreased the rate of TLOSR. This resulted in a significant reduction in oesophageal acid exposure but postprandial LOS characteristics were preserved.

Adult↗

PubMed2001

Ileoanal pouch function is related to postprandial pouch tone.

BACKGROUND: Functional impairments are frequently observed in patients with an ileoanal pouch. Meal ingestion increases pouch tone and motility. Little is known, however, about the influence of meal-stimulated pouch characteristics on pouch function. The aim was to characterize basal and postprandial pouch motor and sensory characteristics in relation to clinical pouch function in patients with an ileoanal pouch. METHODS: Nineteen patients with an ileoanal pouch, without faecal incontinence but with either a high stool frequency (n = 8) or an adequate stool frequency (n = 11), underwent pressure distension of the pouch, by which pouch compliance and sensitivity characteristics were assessed using an electronic barostat. A set pressure procedure was performed to assess the influence of a meal on pouch tone and motility. RESULTS: Mean(s.d.) compliance was 10(6) and 11(4) ml/mmHg in the groups with poor and adequate pouch function respectively (P not significant). Mean(s.d.) visual analogue scale scores (0-10 cm) for urge at the highest pressure of 28 mmHg were 2.3(1.0) versus 2.3(2.4) cm respectively (P not significant); those for pain were 0.8(1.0) versus 0.5(0.7) (P not significant). Postprandially mean(s.d.) pouch volume decreased by 70(24) per cent in the group with poor pouch function and 29(25) per cent in the group with adequate pouch function (P < 0.01). The frequency and amplitude of phasic pouch contractions increased significantly postprandially, but no differences in motility characteristics were observed between the two groups. CONCLUSION: In patients with uniform pouch design and follow-up after pouch construction, pouch compliance and sensitivity were no different between patients with normal and high stool frequency; however, postprandial pouch tone was increased significantly in patients with a high stool frequency.

Adenomatous Polyposis Coli↗

PubMed2001

Effect of triglycerides with different fatty acid chain length on superior mesenteric artery blood flow.

Fat stimulates superior mesenteric artery (SMA) blood flow. Little is known, however, about the influence of fatty acid chain length on SMA flow. The present study was performed to compare the effect of long chain triglycerides (LCT, corn oil), very long chain triglycerides (VLCT, fish oil) and medium chain triglycerides (MCT) on SMA flow. A total of seven healthy volunteers (four men, three women; aged 26 +/- 4 years) participated in three experiments, performed in random order during 60 min continuous intra-duodenal infusion of either LCT (30 mL h(-1); 240 kcal h-1), equicaloric VLCT (30 mL h(-1); 240 kcal h(-1)) or MCT in equimolar (15 mL h(-1); 113 kcal h(-1)) and equicaloric amount (30 mL h(-1); 225 kcal h(-1)). Basal and stimulated SMA blood flow were measured by Doppler ultrasonography. At regular intervals blood samples were taken for measurement of plasma cholecystokinin (CCK) and plasma peptide YY (PYY). Basal SMA blood flow volumes were not significantly different among the LCT, VLCT and MCT experiments (426 +/- 135, 460 +/- 114 and 503 +/- 177 mL min(-1), respectively). The SMA flow increased significantly (P < 0.05) during fat infusion but was significantly higher during LCT (1460 +/- 692 mL min-1) compared with VLCT (1061 +/- 384 mL min-1), MCT 15 mL h(-1) (870 +/- 286 mL min(-1)) and MCT 30 mL h-1 (904 +/- 223 mL min(-1)). Plasma CCK levels increased significantly (P < 0.05) during LCT and VLCT but not during MCT infusion. No correlation was found between SMA flow and plasma CCK levels (r = 0.27; P = 0.2) The SMA blood flow in response to triglycerides is dependent on fatty acid chain length. This chain length-dependent blood flow response is, however, not linear and is not related to plasma CCK levels.

Adult↗

PubMed2001

Analysis and surgical treatment of persistent dysphagia after Nissen fundoplication.

BACKGROUND: After Nissen fundoplication, troublesome dysphagia develops in 5-10 per cent of patients. The mechanism of dysphagia has not been fully resolved, in spite of a number of studies focusing on oesophageal motility and lower oesophageal sphincter (LOS) dynamics. Tightness and length of the wrap have had considerable attention, without giving a fully satisfactory explanation of the pathophysiological mechanism. METHODS: Eighteen patients with persistent dysphagia after Nissen fundoplication needing reoperation were studied. Eighteen patients, matched for age and sex, without dysphagia after Nissen fundoplication were used as controls. Reoperation consisted of conversion of a 360 degrees into a 270 degrees wrap. Barium swallow, endoscopy, oesophageal manometry and 24-h pH monitoring were performed before and after (re)operation. RESULTS: Peristaltic amplitude, velocity and duration of contraction were not significantly influenced by operation. In 16 of 18 patients with dysphagia, LOS relaxation was incomplete and the residual relaxation pressure was significantly higher than that in the group without dysphagia (P < 0.01). No correlation was found between LOS pressure and peristaltic amplitude, nor between LOS pressure and ramp pressure in the distal oesophagus. After reoperation, basal LOS pressure decreased significantly (P < 0.01) and LOS relaxation was complete in all but three patients; residual relaxation pressure decreased (P < 0.01) and was significantly lower than that after uncomplicated Nissen fundoplication. In the latter group, LOS pressure, residual relaxation pressure and ramp pressure increased significantly after operation (P < 0.01). CONCLUSION: A return to complete LOS relaxation and a decrease in residual relaxation pressure play an important role in resolving dysphagia.

Adult↗

PubMed2001

Effect of somatostatin on postprandial gallbladder relaxation.

Although the inhibitory effect of somatostatin (SST) on gallbladder contraction is well known, the influence of SST on gallbladder motility during the late postprandial or relaxation phase has not been studied. We therefore investigated the effect of SST on gallbladder relaxation and gut hormone release during the late postprandial phase. Eight healthy volunteers participated in two experiments performed in random order during continuous infusion of either SST or saline (placebo) starting 2 h after meal ingestion. At regular intervals, gallbladder volumes were measured (ultrasonography) and blood samples were taken for determination of plasma cholecystokinin (CCK), pancreatic polypeptide (PP), peptide YY (PYY) and neurotensin levels (radioimmunoassay). Postprandial gallbladder contraction was similar in both experiments: 68 +/- 4% vs. 66 +/- 4%. During SST infusion, postprandial gallbladder contraction was significantly (P<0.01) reduced (2874 +/- 813% *240 min) compared with saline (9391 +/- 1595% *240 min). Plasma CCK, PP, PYY and neurotensin levels were in the same range in the early postprandial phase but were significantly reduced during SST infusion compared with placebo (late postprandial phase). Plasma levels of CCK correlated with gallbladder volumes during both the contraction and relaxation phase (r=0.68, P=0.01 and r=0.61, P=0.008, respectively). SST enhances gallbladder relaxation and reduces hormone secretion in the late postprandial phase. The results point to an association between CCK and gallbladder volume not only during the postprandial contraction phase but also during the relaxation phase.

Adult↗

PubMed2001

Reproducibility of antroduodenal motility during prolonged ambulatory recording.

Ambulatory recording of antroduodenal manometry is a novel technique with several advantages over standard stationary manometry recording. Although the feasibility of this technique in clinical practice has been demonstrated, reproducibility of antroduodenal motility recorded by means of ambulatory manometry has not been investigated. To test whether antroduodenal motility recorded by ambulatory manometry is reproducible, we performed two 24-h ambulatory antroduodenal manometry recordings in 18 healthy subjects according to an identical protocol with a 1-week interval. Motility was recorded with a five-channel solid-state catheter. Postprandial motility was recorded after consumption of two test meals and interdigestive motility was recorded nocturnally. Postprandial antroduodenal motor characteristics were identical between the separate recordings. The number and duration of nocturnal cycles of the interdigestive migrating motor complex were also in the same range. Phase III characteristics in general were not different between the two recordings. Only minor alterations were observed in the duration of phase III motor fronts with duodenal onset and in the number of interdigestive cycles concluded by duodenal onset phase III. Parameters obtained by qualitative analysis were comparable between the two recordings. The antroduodenal motility pattern, when measured by ambulatory recording with solid state catheters under standardized conditions, is very reproducible.

Adult↗

PubMed2001

Role of cholecystokinin in relaxation of the proximal stomach.

Ingestion of a meal causes proximal gastric relaxation (accommodation). The magnitude of accommodation is related to the fat content of the meal. A role for cholecystokinin (CCK) has been suggested. However, under fasting conditions intravenous CCK to postprandial levels does not induce a similar accommodation. This study further explores the role of CCK in accommodation. A gastric barostat was used in eight healthy persons to study accommodation in response to a carbohydrate meal with intravenous CCK (CH-CCK), carbohydrate meal with intravenous placebo (CH-placebo) and a fat rich meal with intravenous placebo (FAT). VAS scores for satiety and plasma CCK levels were obtained. In the first postprandial hour the FAT meal induced a relaxation of 112 +/- 29 ml, the CH-CCK meal 49 +/- 36 ml and the CH-placebo meal 12 +/- 32 ml (FAT versus CH-placebo P = 0.03; FAT versus CH-CCK P = 0.09). In the second postprandial hour, intragastric bag volume returned to baseline with all meals. The FAT meal had the most pronounced effect with respect to satiety, CH-placebo the least. In the first postprandial hour, plasma CCK levels increased with the CH-CCK and FAT meals but not with the CH-placebo meal; in the second postprandial hour, levels remained elevated with the CH-CCK meal. It is concluded that a carbohydrate meal with exogenous CCK does not induce fundic relaxation, whereas a fat-rich meal (endogenous CCK) does, despite similar plasma CCK levels.

Adult↗

PubMed2001

Proximal gastric motor and sensory function in slow transit constipation.

BACKGROUND: Slow transit constipation may be part of a more generalized gastrointestinal motility disorder. METHODS: Gastric motor and sensory function were evaluated using a barostat in 17 patients with slow transit constipation and in 16 healthy controls. A step-wise isobaric distension procedure was performed, followed by a barostat procedure including a liquid meal. Symptoms were scored using visual analog scales. Plasma levels of gastrointestinal hormones were determined postprandially. RESULTS: Proximal gastric compliance was significantly reduced in the patients. Basal gastric volume did not differ between patients and controls. Postprandial fundus relaxation was significantly reduced in the patients and correlated significantly with daily upper gastrointestinal symptoms. Postprandial secretion of cholecystokinin and gastrin was reduced in the patients. CONCLUSIONS: In patients with slow transit constipation, proximal gastric compliance is reduced and postprandial fundus relaxation is impaired. These findings support the hypothesis that slow transit constipation may be part of a pan-enteric disorder.

Adult↗

PubMed2001

Motor and sensory function of the rectum in different subtypes of constipation.

BACKGROUND: It is not known whether evaluation of motor and sensory function of the rectum using a barostat may help to distinguish subtypes of constipation. METHODS: Motor and sensory function of the rectum have been evaluated using a barostat in 14 patients with slow transit constipation (STC), 12 patients with constipation-predominant irritable bowel syndrome (IBS) and 18 healthy controls. First minimal distending pressure was determined, after which spontaneous adaptive relaxation of the rectum was monitored. Then a step-wise isobaric distension procedure was performed, during which symptom perception was determined. The distension was followed by a 90-min barostat procedure: for 30 min in the basal state followed by ingestion of a semi-liquid meal (postprandial state). RESULTS: Minimal distending pressure was not different between both patient groups and controls, neither was compliance different between constipated patients and controls. The degree of spontaneous adaptive relaxation was in the same range in all groups. During distensions with high pressures, the perception of urge was significantly reduced in STC patients compared to IBS and controls, while the perception of pain was significantly increased in IBS versus STC and controls. Postprandially, a small decrease of rectal volume was only observed in the control group, but not in the patients. CONCLUSIONS: Rectal motor characteristics are not different between patients with constipation-predominant IBS, patients with STC and healthy controls while during isobaric distensions, sensations of urge were reduced in STC and sensations of pain were increased in IBS. Rectal visceroperception testing may help distinguish groups of patients with different subtypes of constipation.

Adult↗

PubMed2001

Provocation of transient lower esophageal sphincter relaxations by gastric distension with air.

OBJECTIVES: Transient lower esophageal sphincter relaxations (TLESRs) are the major mechanism permitting not only gastroesophageal reflux but also venting of air from the stomach. Triggering of TLESRs is provoked by gastric distension. Antireflux surgery is associated with impaired ability to belch. It is not known whether a reduced capacity to belch results from postoperative reduction in TLESRs. METHODS: We studied the occurrence of TLESRs, common cavities (indicator for gas gastroesophageal reflux), and belching after standardized acute gastric distension by air insufflation (750 ml). Control subjects (n = 10), patients with gastroesophageal reflux disease (GERD) (n = 22), and patients after fundoplication (n = 24) were studied. LES and esophageal motilities were recorded with perfusion manometry. RESULTS: Gastric distension with air significantly (p < 0.05) increased TLESR frequency in controls (1.6+/-0.3 to 3.5+/-1.0 per 20 min), GERD patients (1.2+/-0.3 to 3.1+/-0.5 per 20 min), and patients after fundoplication (0.5+/-0.1 to 1.8+/-0.6 per 20 min). Postfundoplication the number of TLESRs was significantly reduced (p < 0.05) both under fasting conditions and after air insufflation. The number of common cavities and belches after gastric air distension also was significantly reduced (p < 0.05) after fundoplication: 2.3+/-0.6 versus 4.7+/-0.4 in controls and 4.1+/-0.4 in GERD patients. About half of the common cavities occurred during TLESRs, and half during other mechanisms. An impaired ability to belch in daily life correlated with an impaired belching response during the test. An impaired ability to belch occurred only in patients with complete fundoplication and not in patients with partial fundoplication and was associated with a reduced number of common cavities after gastric air insufflation. CONCLUSIONS: Short-lasting gastric air distension 1) provokes TLESRs but does not differentiate GERD patients from controls, 2) reveals impaired belching capacity in patients after complete fundoplication, and 3) shows that common cavities do not exclusively occur during TLESRs.

Adult↗

PubMed2001

Influence of gender on proximal gastric motor and sensory function.

OBJECTIVE: Gender-related differences have been demonstrated with regard to GI motility: gallbladder contraction, colonic transit, and gastric emptying are delayed in women. It is not known whether gender influences proximal gastric motility and perception. METHODS: We have studied the influence of gender on proximal gastric motility and perception under fasting and postprandial conditions by retrospective analysis of data obtained in 99 healthy volunteers (42 men, 57 women) who participated in barostat studies performed according to standardized protocols at the Leiden University Medical Center (Leiden, The Netherlands) between 1996 and 2000. RESULTS: Minimal distending pressure (MDP) was significantly higher in women than in men (respectively, 6.8+/-0.2 vs 5.5+/-0.2 mm Hg; p < 0.001). During stepwise pressure distensions pressure-volume curves were similar in both sexes after correction for MDP, whereas perception of fullness and abdominal pressure increased significantly (p < 0.05) more rapidly in women. Before the meal intragastric volumes (at MDP + 2 mm Hg) did not differ between sexes. After the meal gastric relaxation in the first 30 min did not differ in women and men (respectively, 186+/-23 ml and 140+/-32 ml). However, from 30 until 90 min after the meal a significantly (p < 0.05) delayed return of intragastric volume to basal was seen in women. Perception of postprandial nausea was significantly (p < 0.01) increased in women. Perception of postprandial fullness remained increased for a longer period of time in women. CONCLUSIONS: Proximal gastric motility and perception are influenced by gender. Gender-related differences in postprandial proximal gastric motility and perception should be taken into account in barostat studies comparing patients with controls.

Adolescent↗

PubMed2001

Pancreatic polypeptide secretion in patients with chronic pancreatitis and after pancreatic surgery.

AIM: We investigated polypeptide (PP) secretion under basal conditions, in response to bombesin infusion and to meal ingestion in patients with chronic pancreatitis (CP) and patients after different types of pancreatic surgery. METHODS: Included were patients with CP without (n = 20) and with (n = 30) exocrine pancreatic insufficiency, patients after duodenum preserving resection of the head of the pancreas (DPRHP; n = 20), after Whipple's procedure (n = 19), following distal pancreatectomy (DP; n = 12), and healthy controls (n = 36). RESULTS: In CP patients basal and bombesin stimulated PP levels were significantly (p<0.01) reduced compared to controls only when exocrine insufficiency was present. Meal-stimulated PP secretion was significantly (p<0.01-0.05) reduced in CP patients both with and without exocrine insufficiency. Plasma PP peak increments after bombesin and meal ingestion correlated significantly with exocrine function. Basal PP, meal, and bombesin-stimulated PP secretion had low sensitivities of 22%, 42%, and 60% respectively, in detecting chronic pancreatitis. In patients after pancreatic surgery that included pancreatic head resection (DPRHP or Whipple operation) basal and stimulated PP secretion were significantly (p<0.01-0.05) reduced. CONCLUSION: Basal and meal or bombesin-stimulated PP levels are significantly reduced in patients with CP only when exocrine insufficiency is present. Determination of plasma PP levels has low sensitivity and is not useful in detecting chronic pancreatitis without exocrine insufficiency. In patients after pancreatic surgery, PP secretion is dependent on the type of operation (head vs tail resection).

4-Aminobenzoic Acid↗

PubMed2000

[Gastro-intestinal surgery and gastroenterology. V. Chronic pancreatitis: gastroenterologic aspects].

Chronic pancreatitis causes irreversible damage to the pancreatic parenchyma and ultimately leads to exo- and endocrine insufficiency. In the Western world, alcohol is the main cause of chronic pancreatitis; part of the patients with idiopathic or alcoholic pancreatitis conceivably have a raised sensitivity to the toxic effects of alcohol because of a certain genetic predisposition. The most striking symptom, severe recurrent or persistent pain is often difficult to manage. Various forms of imaging examination provide complementary information on lesions of the pancreatic parenchyma, the pancreatic duct, the bile ducts and adjacent structures; ultrasonoscopy is the technique of first choice in case of suspicion of a pancreatic disorder. Endoscopic therapies are booming: sphincterotomy, calculus extraction, insertion of an endoprosthesis in the pancreatic duct and drainage of pseudocysts (transpapillary or through the jejunum or stomach).

Alcoholism↗

PubMed2000

Effects of very long chain versus long chain triglycerides on gastrointestinal motility and hormone release in humans.

Fish oil (a very long chain triglycerides, VLCT) has received much attention because of its favorable metabolic properties; however, its effect on gastrointestinal function has not been studied. We investigated the effects of intraduodenally administered VLCT on gut-hormone release [cholecystokinin (CCK), neurotensin, peptide YY (PYY)], gallbladder emptying, antroduodenal motility, and small bowel transit time (SBTT) in comparison to intraduodenal administration of saline and long chain triglycerides (LCT, corn oil) in nine healthy volunteers. Gallbladder contraction duration was significantly shorter after VLCT than after LCT (138 +/- 16 min vs 233 +/- 38 min, P < 0.05). Both fats induced a fed motility pattern, while SBTT was not significantly altered. CCK secretion was significantly reduced after VLCT compared to LCT (36 +/- 12 pM x 120 min vs 78 +/- 15 pM x 120 min, P < 0.05), whereas PYY and neurotensin release were not significantly different. In conclusion, effects of triglycerides on CCK and gallbladder motility appear to be chain-length dependent, in contrast to the effects on distal gut-hormone release and intestinal motility and transit, which appear to be chain-length independent.

Adolescent↗