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PubMed1979

[Effects of domperidone on gastrointestinal and gallbladder motility and gastric emptying (author's transl)].

Effects of domperidone on gastric emptying and gastric, duodenal and gallbladder motility were investigated. Intravenous injection of domperidone 2 mg/kg produced an acceleration of gastric motility without increase in the tone while a marked increase in the amplitude of peristaltic waves with a slight decrease in frequency was observed. Domperidone also produced an acceleration of duodenal and gallbladder motility. Domperidone produced an acceleration of transit of stomach contents in some cases, while in others gastric emptying was inhibited. This difference of the effect may be due to the previous tone of the pylorus. The excitatory action of domperidone on gastrointestinal motility was suppressed to some degree after cervical vagotomy or vagus cooling and markedly inhibited by atropine. Tetrodotoxin reduced the excitatory effect of domperidone but did not abolish. Therefore, it is presumed that domperidone stimulates, at least in part, the gastrointestinal muscle itself as well as cholinergic neurons in the gastrointestinal wall or cholinergic receptors of the gastrointestinal muscle and that domperidone may also have a central nervous system stimulant action. On the other hand, domperidone appears to act directly on the gallbladder muscle.

Action Potentials↗
PubMedDate not supplied

Psychophysiological factors associated with irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with no known pathophysiological etiology. Many individuals with IBS, however, report higher than normal levels of stress and exhibit abnormal personality characteristics. In this article, the author reviews the psychophysiological factors associated with IBS and discusses gastrointestinal neuroendocrinology, the effects of stress on gastrointestinal motility, and the nursing implications related to this syndrome.

Colonic Diseases, Functional↗
PubMed1983

Gastrointestinal transit of liquids.

A simple, non-invasive technique has been established for the simultaneous measurement of stomach emptying and the small bowel transit of a liquid meal. The rate of gastric emptying (T1/2) was measured in 21 normal subjects by using a gamma camera and computer to observe emptying of 200 ml of water to which 200 muCi 99Tcm - diethylene tetramene pentacetic acid chelate was added. By adding lactulose to the drink and measuring breath hydrogen (H2) concentration, small bowel transit time (Ta) was simultaneously estimated. There was no significant correlation (r = 0.26, P greater than 0.2) between T1/2 and Ta or between T1/2 and the shape of the breath H2 evolution curve. However, the shape of the breath H2 curve did seem to be affected by Ta. The technique should prove useful for the study of gastrointestinal motility in disease states.

Disaccharides↗
PubMed1982

Effects of oral pirenzepine on gastric emptying and antral motor activity in healthy man.

UNLABELLED: Pirenzepine (PIR), in contrast to classical antimuscarinic drugs, shows heterogeneity of binding that corresponds with the pharmacological activity: gastric secretion is inhibited by low doses, whereas higher doses are needed to inhibit gastrointestinal motility. This study investigated the effects of oral PIR on gastric emptying and antral motor activity. 20 healthy men (mean age 24.9 yr) participated in two experimental sessions, one week apart. According to a cross-over double blind design they received, three and a half days prior to the studies, either 50 mg PIR twice daily or placebo (PLA). A semisolid test meal labelled with 150 MBq 99mTc hSA was administered. A gamma camera coupled to a computer monitored modulation depth (MD), frequency (FR), and propagation velocity (PV) of antral contractions together with gastric emptying rate (GE) according to a modification of Akkerman's technique. PIR decreased MD (PLA: 21.2 +/- 1.7 SEM%; PIR: 17.2 +/- 1.5%; P less than 0.005) and increased FR (PLA: 3.12 +/- 0.05 cycles/min; PIR: 3.29 +/- 0.07 c/min; P less than 0.005) significantly whereas PV was accelerated (PLA: 2.9 +/- 0.2 mm/sec; PIR: 3.1 +/- 0.3 mm/sec; n.s.) and GE delayed only slightly (PLA: 50.4 +/- 8.5 kcpm; PIR: 35.5 +/- 6.0 kcpm; n.s.). PIR produced more frequent stools in three and accommodation difficulties and a dry mouth in each two subjects. PLA caused no side effects. CONCLUSION: PIR delays GE insignificantly despite of considerable effects on antral motility.

Adult↗
PubMed1992

Variability of migrating motor complex in humans.

Fasting gastrointestinal motility in the human is characterized by the regular cycling activity of the migrating motor complex (MMC). Our purpose was to define the variability of the MMC within and between a group of six healthy subjects studied for 6-9 hr over six separate days with a perfused catheter system. A total of 88 phase III events was observed during 255 hr of recording in this group. The mean MMC cycling time varied significantly between subjects (range 113-230 min, P less than 0.001), and variation within subjects also was wide (SD range 58-70 min). Seventy-one percent of phase III events commenced in the gastric antrum, 18% in the proximal duodenum, 10% in the distal duodenum, and 1% in the proximal jejunum. For each subject, the velocity of propagation of phase III decreased significantly (P less than 0.001), and phase III duration increased significantly (P less than 0.001), with increasing distance from the os. In the antrum, phase I was predominant, and significant (P less than 0.006) variation between subjects was noted for percentage of MMC cycle occupied by phase I (overall mean +/- SD 55 +/- 23%). Phase II was predominant in both duodenum and jejunum (mean range 70-80%), and no significant variation was noted between subjects for percentage of MMC occupied by phase II. We conclude that human MMC activity varies widely between individuals and within the same individual when studied on separate days.

Adult↗
PubMed2000

Changes of in vivo gastrointestinal motor pattern in pacemaker-deficient (WsRC-Ws/Ws) rats.

In vitro studies on pacemaker-deficient W-mutants have revealed a disappearance of rhythmic contraction in their gastrointestinal tracts. Their contractile force has not been diminished, however. In contrast, W-mutants often present dysmoility-like symptoms with distension of the gastrointestinal tract in vivo. Gastrointestinal motility of W-mutant rats was examined in vivo by an extraluminal strain-gauge force transducer method. We examined a normal gastrointestinal motor pattern in the rats with two distinct motor phases, digestive and interdigestive. Moreover, we detected a failure to form an interdigestive contractile complex in pacemaker-deficient rats. The interdigestive motor activity of the gastrointestinal tract is important for cleaning gastrointestinal tract in preparation for the next meal. The impairment of the interdigestive contractile complex may be related to the dysmoility-like symptoms of W-mutant rats in vivo.

Animals↗
PubMed1984

[The irritable colon].

Gut dysfunction can be demonstrated in 20-30% of normal adults without ever developing real illness. Irritable bowel syndrome is not merely a gastrointestinal disturbance, but involves the whole organism. With respect to etiology a number of factors such as constitution, mental state and environment, colonic motility, gastrointestinal peptides, low residue diet, food intolerance and infections all seem to play a role. Positive diagnosis by electromyography has not gained any clinical relevance. Treatment of gastrointestinal functional disorders is characterized by a considerable positive response to placebo and is oriented towards individual symptoms. Bran and bulking agents are effective when constipation is present, opiate-agonists have a positive influence in diarrhoea, anti-cholinergics may be of some value in abdominal pain, antidepressants and sedatives given for a limited period of time may be beneficial in psychiatric symptoms. The combination most often used in therapy of irritable bowel syndrome consists of sedatives, anticholinergics and bulking agents. Psychotherapy can prolong the positive effects of medical therapy even beyond the treatment period. Long-term follow-up reveals a satisfactory response of the symptomatology in the majority of patients.

Adult↗
PubMed1999

Intragastric capsaicin stimulates motility of upper gut and proximal colon via distinct pathways in conscious dogs.

The aim of the present study was to investigate the effect and mechanism of action of intragastric and intraduodenal capsaicin on gastrointestinal motility. Five mongrel dogs were equipped with eight strain gauge force transducers on the stomach, small intestine, and proximal colon. In the interdigestive state, capsaicin was administered into the gastric or duodenal lumen. The effects of atropine, hexamethonium, ondansetron, and FK888 on capsaicin-induced contractions were studied. Intragastric capsaicin induced contractions within 15 min in the gastric antrum, duodenum, proximal jejunum, and proximal colon. These stimulatory effects were inhibited by atropine at all sites; by hexamethonium in the small intestine and colon; by ondansetron in the antrum, duodenum, and colon; and by FK888 in the antrum and colon, respectively. Intraduodenal capsaicin had no effect on contractility. Stimulation of afferent fibers by capsaicin in the stomach but not in the duodenum augments contractile activity in local and distant regions of the gut via distinct pathways.

Animals↗
PubMed1999

Ageing and endocrine cells of human duodenum.

Motility and secretory disorders of the gastrointestinal tract and associated glands increase with ageing. The duodenum contains several peptide/amine producing cells that play an important role in regulating gastrointestinal motility and secretion. The present study was performed to elucidate changes in these cells that may have arisen as a result of ageing. A total of four age groups of subjects, aged 1-2, 20-29, 40-49 and 60-69 years were studied. The various endocrine cell types were identified by immunohistochemistry and quantified by computerized image analysis, and two parameters were determined; the number of cells/mm3 epithelial cells and the cell secretory index (CSI), which indicates the immunoreactive secretory granule content of the endocrine cells. Chromogranin A- and serotonin-immunoreactive (IR) cells were fewer in 1-2-year-olds than in 20-29-year-olds. Gastrin/CCK-IR cells were significantly more numerous in 1-2-year-olds and 60-69 years-olds than in 20-29-year-olds. Somatostatin-IR cells were more numerous in the 40-49-year-olds than in the 20-29 years-olds. The CSI was higher in chromogranin A-, gastric inhibitory polypeptide (GIP)-, somatostatin- and gastrin/CCK-IR cells in 1-2-year-olds than in 20-29-year-olds. There was no significant sex difference regarding the numbers and CSI of other endocrine cell types. This study established the absence of sex-related differences in all endocrine cell types investigated, regarding numbers and physiological activity. Age, on the other hand, was shown to be associated with changes in the numbers of CCK-, somatostatin- and serotonin-IR, which may have some bearing on the gastrointestinal disorders of the elderly.

Adult↗
PubMed2001

Effects of an alpha(2)-adrenergic agonist on gastrointestinal transit, colonic motility, and sensation in humans.

To characterize alpha(2)-adrenergic control of motor and sensory functions of gastrointestinal tract and colon, we studied dose-related effects of clonidine (placebo or up to 0.3 mg po) by random assignment in 55 healthy humans. Gastrointestinal transit was measured in all subjects; in 35, we assessed colonic compliance, tone, and sensations of gas and pain during phasic distensions. Clonidine did not significantly alter gastrointestinal or colonic transit, but it increased colonic compliance and reduced fasting tone without altering colonic response to a meal. Clonidine significantly reduced aggregate sensation to distensions overall and had significant linear dose-related sensory effects at 8- and 24-mmHg distensions. Effect on pain (including dose-response relationship) was due to 0.3-mg dose for distensions at 24 mmHg. We confirmed that clonidine relaxes fasting colonic tone and reduces sensation of pain. In this study, gut transit was not altered by clonidine, and novel dose-response characteristics and clonidine's effect on gas sensation are provided. Doses as low as 0.05 mg may be effective and potentially useful in reducing colonic tone and gas sensation.

Adrenergic alpha-Agonists↗
PubMed1983

Effect of desamino-cholecystokinin-octapeptide (CCK-7) on the intraluminal pressure and myoelectrical activity of the gall-bladder, stomach, and small intestine in conscious dogs.

Desamino-cholecystokinin-octapeptide (CCK-7) increased the gall-bladder pressure and decreased the gastric pressure following i.v. infusion in conscious dogs. In small intestine and Heidenhain pouch CCK-7 exerted an initial excitatory effect followed by an inhibitory effect on intraluminal pressure and peristalsis. In all organs the effect of CCK-7 on pressure was correlated with a change of spike discharge. CCK-7 is more potent on gastrointestinal motor activity than a Boots preparation of pancreozymin. The results suggest that CCK-7 at doses within the physiological range could be involved in the regulation of gastrointestinal motility.

Animals↗
PubMed2006

Interstitial cells of Cajal: a new perspective on smooth muscle function.

Interstitial cells of Cajal (ICC) were described more than 100 years ago by Ramon y Cajal. For many years these cells were identified only by non-specific histological stains and later, more reliably, by electron microscopy. Ultrastructural features and the anatomical locations of ICC suggested important physiological roles for these cells. A breakthrough occurred in our ability to study ICC when it was recognized that antibodies for Kit could be used to identify ICC, even in living tissues. Signalling via Kit, a receptor tyrosine kinase, is also necessary for ICC development and maintenance of phenotype. Thus, blocking Kit, by a variety of techniques, caused loss of ICC in experimental animals and demonstrated the critical physiological functions of these cells in gastrointestinal motility. Loss of ICC in human gastrointestinal diseases may contribute to the motor pathologies observed. Unrestrained Kit signalling leads to the transformation of ICC and the development of gastrointestinal stromal tumours. Now ICC-like cells have been identified in a variety of smooth muscle tissues, and the race is on to discover whether these cells have equivalent or even novel functions in organs outside the gastrointestinal tract. This perspectives article gives a short overview of the history of ICC research and directions for future investigation.

Animals↗
PubMed2001

[Clinical characteristics and diagnosis of chronic intestinal pseudo-obstruction].

OBJECTIVE: To analyze and determine the clinical characteristics and diagnostic methods of chronic intestinal pseudo-obstruction(CIP). METHODS: We reviewed the medical records of all 23 patients who diagnosed with CIP in Peking Union Medical College Hospital from 1978 to 2000. RESULTS: Twenty three patients fulfilled the diagnostic criteria (9 male, 14 female, median age 50 years, range 4-75 years). The main symptoms at the presentation were abdominal distension(87%), pain(57%), diarrhea(65%), constipation(48%), vomiting(39%) and weight loss(83%). In this group of CIP patients, the abdominal distension was more common and serious than pain, presenting with diarrhea, weight loss and dismotility in esophagus and stomach. Bowel loops and visible peristaltic waves were seldom observed in the CIP patients. The plain film showed the multiple air-fluid levels (17/20, 85%) and generalized intestinal distention and air in colon. The abnormal findings on the barium contrast examination included intestinal dilation (19/23, 83%), weaken peristalses or/and prolongation of transit time (74%) without mechanical lesions. The pseudo-obstruction involved the small intestine (83%) and colon (39%) that determined according to the radiographic features, abnormal gastrointestinal motor functions, findings of endoscopic examination and laparotomy. Eighteen cases were chronic idiopathic intestinal pseudo-obstruction (1 familial myopathy), 5 were secondary to CTD. CONCLUSIONS: Comparison with the typical mechanical obstruction, the presentations of CIP have some relatively characteristics. The clinical diagnosis of CIP can be confirmed on the basis of typical clinical symptoms and radiographic features, abnormal gastrointestinal motility.

Adolescent↗
PubMed1998

[Use of the Valtrac ring for digestive anastomoses in urology: apropos of 16 cases].

The Valtrac ring is a biofragmentable ring used for gastrointestinal anastomoses. Over a two-year period, 15 anastomoses in 16 patients (mean age: 60 years) were performed with the Valtrac ring: 10 ileal, 4 ileocolonic, and 1 jejunojejunal anastomoses. One anastomosis could not be performed because of an excessively narrow ileal lumen. The mean stay in the intensive care unit was 3 days: gastric aspiration was maintained for an average of 1 week, as return of gastrointestinal motility was long, with first flatus on the 6th day and the first stools on the 7th day. Complications consisted of 2 cases of gastrointestinal fistula (11th and 13th days) one of which was fatal, evisceration on the 7th day, a transient partial bowel obstruction and one bowel obstruction treated medically on the 27th day, due to pancreatitis. Our results are not identical to those reported in the literature. It is often difficult to insert the current form of the Valtrac ring into a healthy ileum, as the smallest ring is often too large. In contrast with gastrointestinal surgery, the anastomoses performed in urology involve a non-thickened, non-distended small intestine.

Adult↗
PubMed1988

Role of motility in pathogenesis of constipation and diarrhea.

Several attempts have been made in order to classify the gastrointestinal motility disorders; they are mainly based upon the type of disorder in transit and the region of the gastrointestinal tract affected. Many digestive motor disturbances do not constitute entities, but are pathophysiologic mechanisms that may contribute to the production of symptoms and signs of various diseases. The abnormal interdigestive motility pattern or the migrating motor complex often corresponds to the absence of phase 3 and several observations strongly suggest that this disordered motility pattern is the cause rather than the consequence of intestinal bacterial overgrowth. Disturbances of colonic motility are often associated with diarrhea; however, the nature of motor alterations depends on the diarrheal disease (episodic, continuous with or without pain). Finally, both gastrointestinal and colonic motor disturbances may contribute to the pathogenesis of constipation and diarrhea; however, several findings suggest that colonic motor alterations are the consequence rather than the cause of changes in bowel habits.

Animals↗
PubMed1998

Discrimination of irritable bowel syndrome by non-linear analysis of 24-h jejunal motility.

Conventional analysis of ambulatory longterm manometry of the small intestine has revealed abnormalities in patients with the irritable bowel syndrome (IBS). The aim was to use methods from non-linear dynamics, in particular the concepts of symbolic dynamics and entropy, in order to discriminate motility in IBS from healthy subjects. 24-h jejunal motility was recorded in 30 IBS patients and 30 healthy subjects. Computerized analysis of contraction amplitudes and intercontractile intervals was performed. Both time series were analysed by symbolic dynamics and entropy to quantify the degree of randomness inherent in the signal. During phase II IBS patients exhibited significantly increased entropies for the intercontractile intervals (IBS: 0.978 +/- 0.016, C: 0.965 +/- 0.020, P = 0.004) and for the contraction amplitudes (IBS: 0.978 +/- 0.008, C: 0.970 +/- 0.026, P = 0.05) compared with healthy subjects. In addition, a significantly increased mean contraction amplitude (mmHg) was found in patients (IBS: 25.2 +/- 4.8, C: 22.2 +/- 3.1, P = 0.003). Considering a combination of both parameters, a diagnostic accuracy of 82% was achieved. We conclude that phase II motility of the small intestine is more random in IBS than in health. Symbolic dynamics seems to be a promising new concept for the analysis of long-term gastrointestinal motility recordings.

Adult↗
PubMed2001

Synthesis and evaluation of novel 2-oxo-1,2-dihydro-3-quinolinecarboxamide derivatives as potent and selective serotonin 5-HT4 receptor agonists.

A series of 8'-substituted N-(endo-8-azabicyclo[3.2.1]oct-3-yl)-1-isopropyl-2-oxo-1,2-dihydro-3-quinolinecarboxamides were synthesized. The 5-HT4 receptor agonistic activity was evaluated using the isolated guinea pig ileum preparation. Of the compounds synthesized, N-(endo-8-(3-hydroxypropyl)-8-azabicyclo[3.2.1]oct-3-yl)-1-isopropyl-2-oxo-1,2-dihydro-3-quinolinecarboxamide (15a, TS-951) exhibited the most potent serotonin 5-HT4 receptor agonistic activity. This compound had a high affinity for the serotonin 5-HT4 receptor although it had no affinities for other broad spectrum receptors. Furthermore, it remarkably enhanced gastrointestinal motility in conscious fed dogs without unfavorable effects that non-selective serotonin 5-HT4 receptor agonist has. TS-951 may be useful in improving gastrointestinal dysfunction.

Amides↗
PubMed1998

Motility of the canine pyloric ring following a pylorus-preserving pancreatoduodenectomy.

Recently, function-preserving operations have become popular, and pylorus-preserving pancreatoduodenectomy (PPPD) is frequently performed for diseases of the head of the pancreas. However, there are only a few basic studies on the pyloric function after PPPD. Using strain gauge force transducers (SGTs), we studied the pyloric motility of normal and PPPD dogs. We prepared three normal and three PPPD dogs in which the SGTs were implanted onto the antrum and pyloric ring, etc. In conscious dogs, the spontaneous gastrointestinal motility was recorded, and the plasma motilin concentration was measured during the interdigestive state. Following the administration of exogenous Leu13-motilin, the motility was again recorded. The relaxation and opening of the pyloric ring was observed synchronously with intense contractions of the antrum during the phase III of normal dogs. Phase III-like motility was recorded in the PPPD dogs, which was not a typical periodic motility. The plasma motilin concentration of one PPPD dog could be measured, and the motilin levels during the phase III-like motility were higher than during phase I. The phase III-like motility was induced by Leu13-motilin in both normal and PPPD dogs. The phase III-like motility recorded in the PPPD dogs was not a typical periodic one, and this aberrant motility was considered to be one of the causes of delayed gastric emptying. Phase III-like motility was induced by the administration of Leu13-motilin; therefore, it is possible that Leu13-motilin improved the motility of the pyloric ring after PPPD.

Animals↗