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PubMed2004

Reefs in experimental gastroenterology--cyclic activities of the gastrointestinal tract.

The activity of the upper gastrointestinal tract is periodic. It concerns the gastrointestinal and gallbladder motility, gastrointestinal blood flow, gastric, intestinal, pancreatic and biliary secretions, rate of nutrient absorption, and many other physiological events. Nowadays, the periodic activity of the gastrointestinal tract is considered as a basic physiological pattern in conscious animals and humans. Unfortunately, there are considerable species- and age-related as well as individual differences, therefore experimental protocols should consider first describing the individual periodic pattern in the examined animals. A lot of confusion may appear with data interpretation if the periodic activity is neglected, in particular when low physiological-like doses of test substances are used. For instance, the effect of CCK or VIP administration on the exocrine pancreas may differ from negligible effect to strong one depending of the phase of pancreatic secretion. The action of secretagogues on the gastrointestinal tract will also be discussed in terms of the ultradian and circadian cycles.

Animals↗
PubMed1988

[Circahoral rhythms of the skin biopotentials outside of digestion and their relationship to the periodic motility of the gastrointestinal tract].

Circahoral rhythms of the skin surface potentials recorded simultaneously with periodic motor activity of stomach in 4 dogs and 7 healthy subjects revealed the rhythms to be an electrophysiological equivalent of the latter in dogs. A "migration" of the group potentials in a certain spatial-temporal sequence was observed among the leads. It corresponded to the cycles of periodic motor activity of the stomach in dogs. The circahoral rhythms are a major topic for research in humans, too.

Adult↗
PubMed1988

[Computer-assisted analysis of intestinal sounds for assessing the motility of the gastrointestinal tract].

Intestinal noise analysis by means of a computerized analyser is a method by which various functional states of the gastro-intestinal tract can be diagnosed. Interference noise from respiration and cardiac action can be suppressed by filtering. Frequency patterns determined were in good correlation with the clinical picture and auscultation findings. It is, basically, possible to identify the original causative organ.

Auscultation↗
PubMedDate not supplied

[Physiology of gallbladder motility and its clinical importance].

The role of gallbladder motility (GBM) in gastrointestinal diseases has been frequently ignored. Recently however, the introduction of new diagnostic methods and data on the normal physiology of gallbladder emptying and refilling have placed this interesting area of gastrointestinal motility where it justly deserves. In this way it has been possible to recognize and further study the pathophysiologic mechanisms involved in some clinical situations with a higher-than expected frequency of gallstones (GS). It has also been possible to identify with more clarity the role GBM has in the chain of events that lead to GS development and thus, to plan prevention or therapeutic strategies. The discovery of new drugs with effects on GBM have also permitted to further advance in the knowledge of normal physiologic mechanisms and to have access to possible future treatments. Also pathologic entities have been clearly defined, such as chronic acalculous cholecystitis. In this review we present recent knowledge on normal GBM physiology and its clinical applications as well consequences of its dysfunction.

Cholecystitis↗
PubMed1992

A chimeric analog of human and salmon calcitonin eliminates antigenicity and reduces gastrointestinal disturbances.

The minimum region in salmon calcitonin (sCT) which induces antigenicity and gastrointestinal disturbances has been identified by examining the cross-reactivity of several sCT fragments and CT analogs with antisera from sCT-treated patients, and by examining inhibition of gastrointestinal motility of these sCT fragments and CT analogs in conscious dogs. Sixteen residues at the N-terminus of sCT comprised the minimum fragment capable of inducing both activities. Human CT (hCT) showed no antigenicity and a four-order weaker inhibition of gastrointestinal motility than sCT. Based on these data, we synthesized the human and salmon chimeric CT, ACT-15, in which the 16 N-terminal residues were those of hCT and the 16 C-terminal residues were those of sCT. ACT-15 had no cross-reactivity with the antisera and had almost the same weak gastrointestinal inhibition effect as hCT in dog and rat models. Nevertheless, it retained a hypocalcemic activity and an analgesic activity comparable to sCT. These results suggest that the amino acid residues in the N-terminal half of CT are responsible for the formation of antibodies and the induction of gastrointestinal disturbances, but may not influence calcium metabolism or analgesia. Clinical studies of ACT-15 will be needed to confirm this hypothesis.

Amino Acid Sequence↗
PubMed1986

[Physico-chemical stimulation of dietary origin and digestive motility in the rabbit].

The effects on gastrointestinal motility of two different diets, one containing dehydrated lucerne and the other dehydrated beet pulp (both being either coarsely or finely ground before pelleting) were studied in 16 unanesthetized 50-60-day old rabbits fed ad libitum. The rabbits fed with lucerne had better antroduodenal and ileo-caecal coordination, a higher level of electrical activity on the duodenum, and more frequent migrating myoelectric complexes on the jejunum and ileum than those fed with beet pulp. Furthermore, the rabbits fed the finely ground pellets showed weak electrical activity on the ileum and poor ileo-caecal coordination irrespective of fiber source, suggesting a unique effect of size per se on these portions of the digestive tract.

Animals↗
PubMed1975

Effects of E prostaglandins, diphenoxylate and morphine on intestinal motility in vivo.

The mechanism of the gastrointestinal motility effects of diphenoxylate and morphine in preventing E prostaglandin (PG) diarrhea was investigated. Duodenal motility studies were conducted in the anesthetized dog. Two contractile force transducers were oriented to record contractions from both the circular and longitudinal muscles. In some experiments the basic electrical rhythm (BER) was also recorded. Blood pressure was monitored from the femoral artery and drug injections were made in the femoral vein. Diphenoxylate shared with morphine the capacity to stimulate circular muscle contractions which correlated with the appearance of spike potentials on the BER. Prostaglandin E1 methyl ester (PGE1ME) showed marked relaxation of the circular muscle and abolishment of spike potentials. PGE1ME also blocked the stimulatory effects of diphenoxylate and morphine on the circular muscle. PGE1ME and PGE2 were found to be equally potent in producing diarrhea in mice. Diphenoxylate and morphine were found to be equally potent in inhibiting PG's diarrhea. These studies suggest that the constipating actions of diphenoxylate and morphine are a consequence of the increased circular muscle activity of the intestine.

Animals↗
PubMed1988

Factors differentiating postponed neonatal death from survival in low birth weight infants.

Although survival of low birth weight infants during the neonatal period has improved, an increasing percentage of infants succumb after 28 days but before discharge from the nursery. In a retrospective study we compared 11 postponed neonatal deaths (PND) with survivors matched for birth weight, gestational age, gender, race, inborn or outborn status, and year of birth in an attempt to identify possible differentiating factors early in the clinical course. Evaluation of antenatal, intrauterine, and early nursery events could not differentiate the two groups. By day 14, however, significantly more PND required assisted ventilation because of poor respiratory effort and total parenteral nutrition because of poor gastrointestinal motility. Metabolic differences were noted at this time in the serum bilirubin, phosphorus, and chloride levels. At autopsy all infants had evidence of CNS injury, and moderate chronic lung disease, and in addition nine infants had bronchopneumonia. The major differences between the PNDs and survivors may primarily involve neurologic control of respiration and gastrointestinal motility. Early recognition of PND may have important medical, ethical, and financial implications for newborn intensive care.

Apnea↗
PubMed2006

Irritable bowel syndrome and chronic constipation: emerging drugs, devices, and surgical treatments.

Irritable bowel syndrome (IBS) and chronic constipation (CC) are two of the most common functional disorders of the gut. CC and IBS are estimated to affect up to 20% and 27% of the North American population respectively. Although not life-threatening, CC and IBS can profoundly and negatively affect quality of life and are associated with a significant economic burden related to direct and indirect annual health-care costs. Possible etiologies for IBS and CC include alterations in visceral sensation and gastrointestinal motility. IBS may be caused by disturbances in brain-gut interactions affecting gastrointestinal motility and visceral sensitivity. Research efforts in CC have begun to identify abnormalities in myenteric neurons, alterations in neurotransmitters and their receptors, and incoordination of the muscles of the pelvic floor or anorectum. Both disorders may be influenced by genetic predisposition, environmental factors, and stress. In this article, the safety and efficacy of traditional and emerging therapies for CC and IBS are examined. In addition, their pathophysiology and symptoms are briefly reviewed.

Constipation↗
PubMed1986

The rumination syndrome in adults. A characteristic manometric pattern.

The rumination syndrome is defined as a process in which a person chews regurgitated gastric contents and then either partially ejects or swallows them. We report 12 cases of rumination in which the clinical diagnosis was supported by esophageal and gastrointestinal motility studies. These patients showed a characteristic pressure spike-wave pattern that was associated with regurgitation and was recorded simultaneously at all manometric sites. These spike waves increased significantly in frequency (p less than 0.001) and amplitude (p less than 0.04) during the postprandial period. The underlying gastrointestinal motility was normal except for a small decrease in postprandial antral motility index, with mean (+/- SE) values of 13.2 +/- 0.3 for patients compared with 14.2 +/- 0.3 for eight healthy adult controls (p less than 0.03). Nine patients had significant personality disturbances, including six whose scores on the Minnesota Multiphasic Personality Inventory for hypochondriasis and depression were significantly above the reference population (p less than 0.02). The rumination syndrome should be considered in adult patients with long-standing postprandial vomiting. The manometric pattern is characteristic.

Adolescent↗
PubMed2004

Impaired gallbladder motility and delayed orocecal transit contribute to pigment gallstone and biliary sludge formation in beta-thalassemia major adults.

AIM: Gallbladder and gastrointestinal motility defects exist in gallstones patients and to a lesser extent in pigment gallstone patients. To investigated the role of gallbladder and gastrointestinal motility disorders in pigment gallstone formation in beta-thalassemia major. METHODS: Twenty-three patients with beta-thalassemia major (16 females; age range 18-37 years) and 70 controls (47 females, age range 18-40 years) were studied for gallbladder and gastric emptying (functional ultrasonography), orocecal transit (OCTT, H(2)-breath test), autonomic dysfunction (sweat-spot, cardiorespiratory reflex tests), bowel habits, gastrointestinal symptoms and quality of life (all with questionnaires). Gallbladder content (ultrasonography) was examined before and during 8-12 mo follow-up. RESULTS: Gallstones and/or biliary sludge were found in 13 (56%) patients. beta-thalassemia major patients had increased fasting (38.0+/-4.8 mL vs 20.3+/-0.7 mL, P = 0.0001) and residual (7.9+/-1.3 mL vs 5.1+/-0.3 mL, P = 0.002) volume and slightly slower emptying (24.9+/-1.7 min vs 20.1+/-0.7 min, P = 0.04) of the gallbladder, together with longer OCTT (132.2+/-7.8 min vs 99.7+/-2.3 min, P = 0.00003) than controls. No differences in gastric emptying and bowel habits were found. Also, patients had higher dyspepsia (score: 6.7+/-1.2 vs 4.9+/-0.2, P = 0.027), greater appetite (P = 0.000004) and lower health perception (P = 0.00002) than controls. Autonomic dysfunction was diagnosed in 52% of patients (positive tests: 76.2% and 66.7% for parasympathetic and sympathetic involvement, respectively). Patients developing sludge during follow-up (38%, 2 with prior stones) had increased fasting and residual gallbladder volume. CONCLUSION: Adult beta-thalassemia major patients have gallbladder dysmotility associated with delayed small intestinal transit and autonomic dysfunction. These abnormalities apparently contribute together with haemolytic hyperbilirubinemia to the pathogenesis of pigment gallstones/sludge in beta-thalassemia major.

Adolescent↗
PubMed1988

Abnormalities of the migrating motor complex in diabetics with autonomic neuropathy and diarrhea.

Diarrhea is a common symptom in long-standing diabetes. The pathogenesis of this diarrhea remains obscure, although it appears to be related to the development of autonomic neuropathy, which may cause several abnormalities including altered gut motility. We studied fasting gastrointestinal motility for a mean of 210 min in a group of 12 type-II diabetics with diarrhea. All patients had peripheral neuropathy and symptoms of autonomic neuropathy. Their motor activity was compared with that of a group of six normal volunteers. In addition, gastrointestinal transit time was assessed by the hydrogen breath test. The presence of bacterial overgrowth was assessed by the hydrogen breath test and culture of jejunal secretions. The diabetics showed grossly disordered motor activity. There was a complete absence of phase-III activity in two patients. Most phase III's commenced in the distal duodenum or jejunum. The phase-III component was often of short duration at each recording site. There was increased velocity of propagation between sites. Continuous phase-II activity was noted in some patients. Antral activity was absent or reduced during phase II. Gastrointestinal transit time was significantly prolonged in the diabetics. Bacterial overgrowth was demonstrated in three diabetic subjects. These motility abnormalities are nonspecific and are unlikely to play a major role in the pathogenesis of diabetic diarrhea.

Adult↗