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PubMed2003

Postoperative colonic motility in patients following laparoscopic-assisted and open sigmoid colectomy.

Clinical reports on laparoscopic-assisted sigmoid colectomy (LASC) suggest that the period of postoperative inhibition of gastrointestinal motility is shortened as compared to open sigmoid colectomy (OSC). We aimed to specifically investigate whether colonic motility increases more rapidly following LASC compared to OSC. LASC was performed in 11 patients and OSC in nine patients for recurrent diverticulitis or carcinoma. During surgery a manometry catheter was inserted into the colon via the anus, and the tip was placed in the splenic flexure. Continuous manometric recordings were performed from the day of surgery until postoperative day 3 with a four-channel microtransducer manometry system combined with a portable data logger. The postoperative colonic motility index was 101+/-18, 199+/-30, and 163+/-27 mm Hg/min on days 1, 2, and 3 after LASC, respectively, which was increased compared to indexes of 53+/-15, 71+/-18, and 76+/-23 following OSC (mean+/-standard error of the mean; P<0.05). The amplitude but not the frequency of contractions was higher following LASC compared to OSC. Following LASC, patients requested a similar amount of pain medication but resumed oral food more rapidly on postoperative days 2 and 3 (P<0.05), and they were discharged from the hospital earlier (P<0.05). Colonic motility in particular and the patient's condition in general seem to improve more rapidly following LASC compared to the open procedure.

Adult↗
PubMed1989

[Effects of trimebutine on intestinal motility in dogs].

The effects of intravenous, oral, intracerebroventricular and local intra-arterial administration of trimebutine were investigated in dogs whose digestive tract had been fitted with electrodes and strain gauge transducers. In fasted conscious dogs, trimebutine (5 mg/kg) stimulated small bowel motility with induction of a propagated phase of regular spiking activity. This stimulation was associated with weak inhibition of gastric motility and a biphasic response of the colon characterized by stimulation followed by inhibition. By the oral route, trimebutine (20 mg/kg) stimulated gastrointestinal motility. The duration of the intestinal migrating phase 2 was increased whereas an additional migrating phase 3 developed. These effects were associated with an increase in colonic contractions lasting two hours. The stimulating effect of trimebutine (phase 3) on intestinal motility was not reproduced after intracerebroventricular administration and was abolished by previous intravenous, but not intraventricular, administration of naloxone. The local effects of trimebutine on the circular muscle of canine gastrointestinal tract were studied after close intra-arterial injection in anesthetized dogs. Under these conditions, the drug stimulated the resting gut through its neural and direct smooth muscle components while it inhibited the contractions induced by field stimulation. In conclusion, the excitatory effect of trimebutine seems to be mediated by mu or delta receptors while its inhibitory activity might involve kappa opiate receptors.

Administration, Oral↗
PubMed1985

Plasma motilin concentration and interdigestive migrating motor complex in diabetic gastroparesis: effect of metoclopramide.

The objective of this study is to determine whether abnormal rhythm and amplitude of the oscillation in plasma motilin concentration are responsible for the abnormal motility observed in patients with diabetic gastroparesis. We also investigated the effect of metoclopramide on plasma motilin concentration and gastrointestinal motility in these patients. In healthy controls, basal plasma motilin concentration fluctuated in phase with the interdigestive migrating motor complex. All patients with diabetic gastroparesis did not have antral phase III activities and had significantly higher basal motilin concentrations, which maintained a normal oscillatory pattern. Administration of metoclopramide initiated antral phase III activities in healthy controls and in patients with diabetic gastroparesis. These were accompanied by a concurrent rise in plasma motilin concentration in healthy controls, contrasting with a fall in plasma motilin concentrations in patients with diabetic gastroparesis. We conclude that diabetic gastroparesis is associated with absence of antral interdigestive migrating motor complex and with elevated plasma motilin concentration with normal cyclic fluctuations. Our studies also show that metoclopramide initiates antral phase III activities in diabetic gastroparesis independent of plasma motilin concentration.

Adolescent↗
PubMed1992

Patterns of propulsive motility in the human colon after abdominal operations.

Twenty patients about to undergo elective cholecystectomy who were not using laxatives or drugs known to affect gastrointestinal motility and who did not give a history of gastrointestinal disease were investigated in a prospective open study. Patients swallowed two capsules each containing four radio-opaque markers every 12 hours starting 48 hours before operation. The pattern of resolution of postoperative colonic paralysis was monitored by serial abdominal radiographs taken every 12 hours until motility had returned to the rectum/sigmoid colon. In all 17 patients who completed the study propulsive motility started significantly earlier in the right colon (mean 61 hours) than in any other part (p less than 0.01). The gradient of resolution of postoperative colonic paralysis was always from proximal to distal, adding to the accumulating body of experimental evidence that implicates the right colon to return to normal first.

Abdomen↗
PubMed1980

Antagonistic changes of gastric and colonic motility during selective thermal stimulation of thoracic and lumbosacral cords in anesthetized dogs.

Changes in gastric and distal colonic motility evoked by thermal stimulation of the thoracic and lumbosacral cords, either individually or simultaneously, were investigated in spinal-intact dogs and in dogs spinalized at the cervical level. Simultaneous cooling of the thoracic and lumbosacral cords increased both gastric and colonic motility before and after spinalization. The direction of the responses evoked by simultaneous heating was the opposite, but only the decrease in gastric activity in the spinal-intact dog was significant. Selective cooling of the thoracic cord increased gastric motility, but decreased colonic motility before and after spinalization. Selective heating decreased gastric motility before and after spinalization, and increased colonic motility before spinalization. Selective cooling of the lumbosacral cord decreased gastric motility and increased colonic motility in spinal-intact dogs. No significant responses could be observed during selective heating in spinal-intact dogs. However, in spinalized dogs, the selective cooling and heating increased and decreased colonic motility respectively, while no significant change was observed in gastric motility during the cooling and the heating. It is concluded from the results that thermal stimulation of the spinal cord directly affects spinal functions which control gastrointestinal motility, and that there exists a mutual inhibitory interaction between the thoracic and lumbosacral innervation of the gastrointestinal tract.

Animals↗
PubMed1996

Mebeverine alters small bowel motility in irritable bowel syndrome.

BACKGROUND AND AIM: Despite its widespread use in irritable bowel syndrome (IBS), limited clinical data exist on the effects of mebeverine hydrochloride on gastrointestinal motility. Human motor activity in the small bowel is more reproducible than that in the large bowel; therefore the aim of this study was to determine in the small bowel the effects of oral mebeverine in both IBS patients and in healthy controls. METHODS: Twelve IBS patients (11 females/1 male, 46 +/- 13 years old)-predominant constipation (IBS-C, n = 6) and predominant diarrhoea (IBS-D, n = 6)-and six healthy controls, underwent continuous 48 h ambulant recording of small bowel motor activity. One low energy (400 kcal) and one high energy (800 kcal) standard meal were administered in each consecutive 24-h period. Subjects received, in blinded fashion, placebo tablets in the first 24 h then mebeverine 135 mg q.d.s. in the second 24 h. RESULTS: Mebeverine had no effect on parameters of small bowel motility in controls. In contrast, in both IBS-C (P = 0.01) and IBS-D (P < 0.05) patients, phase 2 motility index was increased during mebeverine administration. Also, after mebeverine the proportion of the migrating motor complex cycle occupied by phase 2 was reduced in IBS-D (P = 0.01), while phase 2 burst frequency was reduced in IBS-C (P < 0.05). For phase 3 motor activity in IBS-C patients, the propagation velocity was decreased (P < 0.01), and the duration increased (P < 0.01). CONCLUSIONS: These findings suggest that mebeverine, in the initial dosing period, has a normalizing effect in the small bowel in IBS, enhancing contractile activity in a similar fashion to 'prokinetic' agents, as well as producing alterations in motor activity consistent with an 'antispasmodic' effect.

Administration, Oral↗
PubMed2005

Spatiotemporal electrical and motility mapping of distension-induced propagating oscillations in the murine small intestine.

Since the development of knockout animals, the mouse has become an important model to study gastrointestinal motility. However, little information is available on the electrical and contractile activities induced by distension in the murine small intestine. Spatiotemporal electrical mapping and mechanical recordings were made from isolated intestinal segments from different regions of the murine small intestine during distension. The electrical activity was recorded with 16 extracellular electrodes while motility was assessed simultaneously by tracking the border movements with a digital camera. Distension induced propagating oscillatory contractions in isolated intestinal segments. These propagating contractions were dictated by the underlying propagating slow wave with superimposed spikes. The frequencies, velocities, and direction of the propagating oscillations strongly correlated with the frequencies (r = 0.86), velocities (r = 0.84), and direction (r = 1) of the electrical slow waves. N(omega)-nitro-L-arginine methyl ester decreased the maximal diameter of the segment and reduced the peak contraction amplitude of the propagating oscillatory contractions, whereas atropine and verapamil blocked the propagating oscillations. Tetrodotoxin had little effect on the maximal diameter and peak contraction amplitude. In conclusion, distension in the murine small intestine does not initiate peristaltic reflexes but induces a propagating oscillatory motor pattern that is determined by propagating slow waves with superimposed spikes. These spikes are cholinergic and calcium dependent.

Animals↗
PubMed1976

Effect of bombesin, a natural tetradecapeptide, on myoelectrical and mechanical activity of isolated, ex vivo perfused, canine stomach.

Electrical and mechanical activity were recorded from the canine stomach, isolated and ex vivo perfused with homologous blood. The action of Bombesin, a natural tetradecapeptide, was compared with the action of pentagastrin, methacholine and electrical stimulation on the electrical and mechanical activity of this isolated preparation. All drugs used and vagal stimulation resulted in premature control potentials, uncoupling of the normal phase locked pattern of electrical control activity, appearance of response activity and appearance of mechanical reaction. These responses were blocked or decreased by atropine, tetrodotoxin and hexamethonium. It appears that the neural release of acetylcholine is implicated in the mechanism of action of Bombesin gastrointestinal motility.

Action Potentials↗
PubMed1993

Inhibition of intestinal motility and reversal of postlaparotomy ileus by selective alpha 2-adrenergic drugs in the rat.

BACKGROUND: The effects of selective alpha-agonist medetomidine and alpha 2-antagonist atipamezole on gastrointestinal motility were studied. METHODS: The passage of intragastrically administered Evans blue in the small bowel of unanesthetized rats was followed, and the stomachs were weighted after killing the rats. RESULTS: Subcutaneous medetomidine, 0.01-0.1 mg/kg, was found to delay small intestinal transit but not gastric emptying, with a maximal effect seen at 0.03 mg/kg. Atipamezole fully reversed the effect of 0.1 mg/kg of medetomidine with a dose of 2.5 mg/kg. Atipamezole alone did not affect small intestinal transit. Subcutaneous morphine, 6 mg/kg, delayed gastric emptying and small intestinal transit, whereas intraperitoneal morphine only delayed gastric emptying. Subcutaneous atipamezole, 0.06 mg/kg, was partially able to reverse the delayed intestinal transit but did not inhibit morphine-induced gastric retention. Subcutaneous atipamezole, 0.06 mg/kg, reversed laparotomy-induced ileus completely. CONCLUSIONS: Atipamezole may provide a useful treatment for postlaparotomy ileus.

Adrenergic alpha-Agonists↗
PubMed1993

Effects of cholecystokinin and gastrin on gastroduodenal motility and coordination in chickens.

Cholecystokinin (CCK) has not been isolated from chicken gut yet and there has been no study on the effects of chicken gastrin (CG), the only gastrin/CCK peptide isolated from avian gut, on gastrointestinal motility. The main objective was to study the effects of CCK and CG on gastroduodenal motility and coordination in chickens. Electrodes for electromyography were implanted in the stomach and proximal and distal duodenum of 4 wk old chickens. Sulphated CCK-octapeptide (CCK8) (10(-10) to 10(-8) moles/kg), CCK-tetrapeptide (CCK4) (2 x 10(-10) to 2 x 10(-8) moles/kg) and CG (3 x 10(-10) to 10(-8) moles/kg) were given in a 10 min i.v. infusion. All these peptides induced a dose-dependent inhibition of gastric motility. CCK8 induced a duodenal hyperactivity whereas CCK4 and CG induced a duodenal inhibition. Neither the CCK-A receptor antagonist L364,718 nor the CCK-B receptor antagonist L365,260 (10(-9)-10(-7) moles/kg) antagonized CCK8 actions. From these results we suggest that the receptors mediating CCK effects are different from those of mammals. The site of action for these peptides is the same in the stomach whereas in the duodenum there are two different ones, one mediating excitation and the other inhibition. These results suggest a physiological role for CCK regulating gastroduodenal motility in birds.

Animals↗
PubMed1989

Differential effects of acute mental stress on interdigestive secretion of gastric acid, pancreatic enzymes, and gastroduodenal motility.

To study the effects of acute mental stress on gastric and pancreatic secretion, 12 healthy fasting volunteers swallowed two multilumen tubes, which allowed continuous aspiration of gastric and duodenal juices and measurement of motility of the stomach and the duodenum. In each study at least three duodenal phase III complexes of the migrating motor complex were recorded. In randomized order after the first or second duodenal phase III, mental stress was induced for 60 min by means of solving anagrams and doing mental arithmetic. Mental stress significantly increased the duration of the migrating motor complex by 60% (137.9 +/- 16.3 vs 86.1 +/- 13.0). Gastric flow rate and gastric acid output were not significantly altered. Duodenal flow rate was not changed during the stress period but significantly decreased by more than 52% in the following 30-min resting period. Duodenal concentration and output of chymotrypsin were significantly increased during the second 30-min period of acute mental stress; chymotrypsin output was significantly reduced in the poststress period. We conclude that acute mental stress has different effects on the stomach, the pancreas, and the upper gastrointestinal motility. The mechanisms by which the central nervous activity induced by mental stress affects the motility and secretion of the upper gastrointestinal tract remain to be elucidated.

Adult↗
PubMed1998

Strain gauge transducer technique for investigation of the pathophysiology of postoperative colonic ileus in awake rats.

Postoperative inhibition of colonic motility is a major contributor to postoperative ileus, but only limited information is available on its pathophysiology. We developed a model to record perioperative gastrointestinal motility in awake rats and investigated the effect of nitric oxide (NO) synthesis blockade on postoperative colonic ileus in rats. Rats were equipped with an i.v. catheter. Two strain gauge transducers were sutured to the colon, and the effects of NO synthesis blockade on postoperative colonic motility were investigated. NO synthesis blockade slightly increased baseline colonic motility. Abdominal surgery profoundly inhibited colonic motility. Blockade of NO synthesis did not prohibit intraoperative inhibition of colonic motility, but significantly hastened recovery of postoperative colonic ileus compared to vehicle. We established a model to record gastric, small intestinal and colonic motility in awake rats postoperatively. Laparotomy and short manipulation of the cecum produced a prolonged inhibition of colonic motility. Inhibition of NO synthesis improved recovery of postoperative colonic motility, indicating that NO partly mediates postoperative colonic ileus in rats.

Animals↗
PubMedDate not supplied

The importance of 5-hydroxytryptamine receptors in the gut.

Most of the 5-hydroxytryptamine (5-HT) present in the adult human body is located in the gastrointestinal tract. The vast majority is contained in enteroendocrine cells, the rest exists mainly in myenteric interneurons separated from the mucosa by an intraenteric barrier. Physiological studies suggest that 5-HT plays a vital role in mediating both sensory and reflex responses to gastrointestinal stimuli and, thus, this transmitter is closely implicated in gut reactions. This review outlines some of the evidence for different 5-HT receptors, summarizes the role of 5-HT in mediating gut sensitivity and motor activity, secretion and more complex activities, such as emesis and diarrhoea and identifies the clinical role of drugs acting on 5-HT receptors in the treatment of emesis, diarrhoea, the control of abdominal pain and discomfort and the rectification of gastrointestinal motility.

Abdominal Pain↗
PubMed1999

Role of neurokinin 3 receptors on responses to colorectal distention in the rat: electrophysiological and behavioral studies.

BACKGROUND & AIMS: Tachykinins contribute to the control of gastrointestinal motility and modulation of somatic and visceral pain. The role of neurokinin (NK) B and NK3 receptors in visceral pain and gastrointestinal disorders has not been determined. METHODS: Using electromyographic recordings of both abdominal and colonic muscle and electrophysiological recordings of pelvic nerve afferent fibers, we studied drug effects on responses to colorectal distention. RESULTS: In awake rats, intraperitoneal administration of the NK3-receptor antagonist SR 142,801 reduced, whereas the NK3-receptor agonist senktide increased, both the rectocolonic inhibitory reflex and abdominal contractions produced by colorectal distention. In contrast, intracerebroventricular administration of SR 142,801 increased the number of abdominal contractions without affecting the rectocolonic inhibitory reflex produced by colorectal distention. In a similar manner, intracerebroventricular injection of senktide diminished the number of abdominal contractions. In electrophysiological experiments, SR 142,801 decreased responses of pelvic nerve afferent fibers to colorectal distention. Responses of pelvic nerve fibers to urinary bladder distention, however, were unaffected by SR 142,801. CONCLUSIONS: These results suggest that peripheral NK3 receptors are involved in the mediation of both visceral nociception and gastrointestinal disorders. Also, central NK3 receptors seem to play a role in the modulation of visceral nociception.

Animals↗
PubMed1975

The movement of an unemulsified oil test meal and aqueous- and oil-phase markers through the intestine of normal and bile-diverted rats.

An unemulsified oil test meal containing aqueous- and oil-phase markers (PEG and 3-H labelled triether) was fed to control and bile fustula rats. PEG moved ahead of the lipid phase in all groups, and was of limited value as a marker for the test meal. Triether was an excellent marker for studies of gastric emptying. An unexpectedly high correlation was seen between the triether and the test meal and its digestion products in the intestine. The results suggest that triether is a valid marker for following the movement of lipid through the bowel under the conditions of this study. Triether/fat ratios indicated that fat absorption occurred largely from the upper small bowel in control animals and from the lower small bowel in the absence of bile. Bile diversion resulted in more rapid gastric emptying initially, but very slow gastric emptying of the last part of the oil test meal. Intestinal transit of test meal or either marker was not significantly affected by bile diversion. No evidence for a direct effect of bile diversion on gastrointestinal motility was found.

Animals↗
PubMed2002

Influence of mosapride citrate on gastric motility and autonomic nervous function: evaluation by spectral analyses of heart rate and blood pressure variabilities, and by electrogastrography.

BACKGROUND: Mosapride citrate selectively acts on serotonin (5-HT(4)) receptors, thus accelerating gastrointestinal motility via acetylcholine. However, few studies have evaluated the influence of mosapride citrate on autonomic nervous activity and hemodynamics. METHODS: The changes in autonomic nervous activity, QT interval, and QT dispersion resulting from the administration of mosapride citrate were studied. Blood pressure, electrocardiograms (ECGs), percutaneous electrogastrograms (EGGs), and ultrasonography were recorded in 20 healthy adult volunteers before and after mosapride citrate (10 mg) was administered. Autonomic nervous activity was evaluated by spectral analyses of heart rate and blood pressure variabilities. Serial changes in low-frequency components (LF, 0.04-0.15 Hz), high-frequency components (HF, 0.15-0.40 Hz), and the LF/HF ratio were investigated. RESULTS: The mean peak power of EGG increased significantly, from 86 +/- 34 microV to 131 +/- 49 microV, after the administration of mosapride citrate (P < 0.05). Gastric emptying significantly increased after the administration of mosapride citrate (P < 0.05). However, neither blood pressure nor heart rate changed significantly after the drug was administrated. In addition, spectral analyses of heart rate and blood pressure variabilities showed no significant changes in autonomic nervous activity parameters, QT intervals, or QT dispersions. CONCLUSIONS: Mosapride citrate increased gastric motility and emptying without influencing autonomic nervous activity, suggesting that it may be very useful for elderly patients or patients with autonomic imbalance.

Adult↗
PubMed2004

Clinical study on the effects of nizatidine on gastric motility and cardiac autonomic function. Investigations using electrogastrography and spectral analysis of heart rate variability.

Nizatidine (CAS 76963-41-2, Acinon), an H2 receptor antagonist, not only inhibits acid secretion but also improves gastrointestinal motility. However, autonomic nervous function has not been studied in detail using electrogastrography (EGG). In the present study, two protocols were adopted to study nizatidine's effects on cardiac autonomic function and gastric motility. Protocol I--Acute: "Group C-I": 10 healthy volunteers received a single oral dose of nizatidine 150 mg. Protocol II--Chronic: "Group DM without N": 15 patients with diabetes mellitus (DM) were observed prior to administration of nizatidine. "Group DM with N": The same 15 patients with DM received nizatidine 300 mg/day for more than 30 days. "Group C-II": This control group was composed of 15 healthy volunteers not receiving nizatidine. In all groups, EGGs were recorded before and after a meal, and autonomic nervous function and QT interval of ECG dispersions were simultaneously evaluated. In Group C-I, nizatidine significantly increased the peak power amplitude of 3 cycles/min (cpm) frequency, but did not significantly change the dominant frequency of the 3-cpm waves. In Group DM with N, nizatidine administration significantly increased the peak power amplitude from 2.4 cpm or a lower frequency (bradygastria) to 3 cpm. Prior to nizatidine administration but after eating a meal, the peak power amplitude on EGG was not increased in Group DM without N. In Group DM with N, however, the EGG peak power amplitude increased to levels similar to those of the healthy subjects (Group C-II). Neither the single nor the chronic administration of nizatidine significantly prolonged the QT interval or increased the QT dispersion. A spectral analysis of heart rate variability showed that nizatidine administration, whether acute or chronic, did not significantly change the indices of autonomic nervous activity. Nizatidine may promote gastric emptying by inhibiting acetylcholine esterase, thus increasing cholinergic activity, and by acting directly on gastric smooth muscle. The results indicate that because nizatidine increases gastric motility without exerting a negative influence on the autonomic nerves, it may be a useful drug in patients with diabetic neuropathy.

Anti-Ulcer Agents↗
PubMed1998

Relevance of gastrointestinal motor disturbances in functional dyspepsia.

Gastrointestinal motor abnormalities are frequent findings in patients with functional dyspepsia. However, these abnormalities are rather non-specific and seem to be restricted to a proportion of patients. Furthermore, they are not necessarily time-linked to symptom perception. The relationship of digestive motor derangements and symptoms in functional dyspepsia remains, therefore, unsettled. A variety of methodological and conceptual shortcomings characterize many of the studies investigating the relationship between gastrointestinal motility disorders and dyspeptic symptoms, and this obviously contributes to a higher level of uncertainty in the field. Recent reports suggest that gastrointestinal dysmotility is associated with perception of some dyspeptic symptoms, at least in a subset of patients. Well-conducted studies using appropriate methodology are needed to verify whether gastrointestinal motor disorders play a causal role in functional dyspepsia and whether this is of clinical relevance.

Dyspepsia↗