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At least 19 recordsLinked to original sources
PubMed2006

Determinants of symptom pattern in idiopathic severely delayed gastric emptying: gastric emptying rate or proximal stomach dysfunction?

BACKGROUND: Idiopathic gastroparesis is a syndrome characterised by severely delayed gastric emptying of solids without an obvious underlying organic cause. Although delayed gastric emptying is traditionally considered the mechanism underlying the symptoms in these patients, poor correlations with symptom severity have been reported. AIMS: To investigate proximal stomach function and to study the correlation of delayed gastric emptying and proximal stomach dysfunction with symptom pattern and severity in idiopathic gastroparesis. METHODS: 58 consecutive patients (19 men, mean (standard deviation) age 41 (2) years) with severely delayed solid gastric emptying (gastric half-emptying time (t(1/2))>109 min) without an organic cause were recruited. They filled out a symptom-severity questionnaire and underwent a gastric barostat study for assessment of gastric sensitivity and accommodation. Correlation of these mechanisms with symptom pattern and overall symptom severity (sum of individual symptoms) was analysed. RESULTS: At two different cut-off levels for gastric emptying (upper limit of normal t(1/2) up to 1.5 and 2 times), no significant change in symptom pattern occurred. 25 (43%) patients had impaired accommodation, and this was associated with higher prevalence of early satiety (p<0.005) and weight loss (p = 0.009). 17 (29%) patients had hypersensitivity to gastric distension, and this was associated with higher prevalences of epigastric pain (p = 0.005), early satiety (p = 0.04) and weight loss (p<0.005). Overall symptom severity was not correlated with gastric emptying or accommodation, but only with sensitivity to gastric distension (R = -0.3898, p = 0.003) and body weight (R = -0.4233, p = 0.001). CONCLUSIONS: In patients with idiopathic gastroparesis, the symptom pattern is determined by proximal stomach dysfunction rather than by the severity of delayed emptying.

Adult↗
PubMed2005

Effects of vasopressin and long pulse-low frequency gastric electrical stimulation on gastric emptying, gastric and intestinal myoelectrical activity and symptoms in dogs.

The aim of this study was to investigate the effect of vasopressin and long pulse-low frequency gastric electrical stimulation (GES) on gastric emptying, gastric and intestinal myoelectrical activity and symptoms in dogs. The study was performed in eight healthy female dogs implanted with four pairs of gastric serosal electrodes and two pairs of small bowel serosal electrodes, and a duodenal fistula for the assessment of gastric emptying. Each dog was studied in three sessions on three separate days in a randomized order with recordings of gastric and small bowel slow waves. Each study session consisted of 30-min baseline, 30-min stimulation and 30-min recovery period. In sessions 1 and 2, infusion of either saline or vasopressin (0.75 U kg(-1) in 30 mL saline instilled in 30 min) was given during the second 30-min period. The protocol of session 3 was the same as session 2 except long pulse-low frequency GES was performed during the second 30-min period. It was found that: (i) Vasopressin significantly delayed gastric emptying 30 and 45 min after meal and GES did not improve the vasopressin induced delayed gastric emptying; (ii) Vasopressin induced gastric dysrhythmias and GES significantly improved vasopressin induced gastric dysrhythmia; (iii) Vasopressin also induced intestinal slow wave abnormalities but GES had no effect on vasopressin induced small bowel dysrhythmia; (iv) Vasopressin induced symptoms and behaviours suggestive of nausea that were not improved by GES. We conclude that: (i) Vasopressin delays gastric emptying and induces gastric and small bowel dysrhythmias and symptoms in the fed state, and (ii) long pulse-low frequency GES normalizes vasopressin induced gastric dysrhythmia with no improvement in gastric emptying or symptoms.

Animals↗
PubMed2005

Characterisation of alpha2-adrenoceptor subtypes involved in gastric emptying, gastric motility and gastric mucosal defence.

The effect of clonidine on ethanol-induced gastric mucosal damage, gastric emptying and gastric motility was compared. The clonidine-induced gastroprotective effect (0.03-0.09 micromol/kg, s.c.) was antagonised by yohimbine (5 micromol/kg, s.c.), prazosin (0.23 micromol/kg; alpha2B-adrenoceptor antagonist) and naloxone (1.3 micromol/kg, s.c.). Clonidine also inhibited the gastric emptying of liquid meal (0.75-3.75 micromol/kg, s.c.) and gastric motor activity (0.75 micromol/kg, i.v.) stimulated by 2-deoxy-D-glucose (300 mg/kg, i.v.). Inhibition of gastric emptying and motility was reversed by yohimbine (5 and 10 micromol/kg, s.c., respectively), but not by prazosin (0.23 micromol/kg, s.c.) or naloxone (1.3 micromol/kg, s.c.). Oxymetazoline-an alpha2A-adrenoceptor agonist-inhibited both gastric emptying (0.67-6.8 micromol/kg, s.c.) and motility (0.185-3.4 micromol/kg, i.v.), whereas it failed to affect gastric mucosal lesions. The results indicate that in contrast to the gastroprotective effect, which is mediated by alpha2B-adrenoceptor subtype, alpha2A-adrenoceptor subtype may be responsible for inhibition of gastric emptying and motility. However, the site of action (central, peripheral, both) remains to be established.

Adrenergic alpha-Agonists↗
PubMed2004

Gastric emptying, gastric secretion and enterogastrone response after administration of milk proteins or their peptide hydrolysates in humans.

BACKGROUND: The influence of protein fractionation on gastric emptying and rate of appearance of their constituent amino acids in peripheral blood remains unknown. AIM OF THE STUDY: To examine the influence of the degree of protein fractionation on gastric emptying, gastric secretion, amino acid absorption and enterogastrone response, after the intragastric administration of complete cow milk proteins or their respective peptide hydrolysates in man. METHODS: Six healthy males were randomized to receive one of the following four solutions: whey whole protein (W), casein whole protein (C), whey peptide hydrolysate (WHY) or casein hydrolysate (CAHY). All solutions were matched for volume (600 mL), nitrogen content (9.3 g/L), energy density (1069-1092 kJ/L), osmolality (288-306 mosmol/kg), pH (6.9-7.0) and temperature (37 degrees C). RESULTS: Solutions were emptied at similar rates, with mean half-times of (mean +/- SEM) 21.4 +/- 1.3, 19.3 +/- 2.2, 18.0 +/- 2.5 and 19.4 +/- 2.8 min, for the WHY, CAHY, C and W, respectively. The rates of intestinal absorption of water and amino acids were similar with the exception of the casein protein solution, for which the speed of intestinal amino acid absorption was slower (p < 0.05). The peptide hydrolysates elicited about 50% more gastric secretion than the whole protein solutions ( p < 0.05),which was accompanied by higher glucose-dependent insulinotropic polipeptide (GIP) plasma levels during the first 20 min of the gastric emptying process. Similar glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) plasma responses were elicited by the four solutions. CONCLUSIONS: The rate of gastric emptying and the plasma GLP-1 and PYY responses to feeding with cow milk protein solutions in humans are independent of the degree of protein fractionation and are not altered by small differences in the amino acid composition or protein solubility. In contrast, the GIP response is accentuated when milk proteins are delivered as peptide hydrolysates.

Adult↗
PubMed1984

Gastric function and obesity: gastric emptying, gastric acid secretion, and plasma pepsinogen.

Because rapid gastric emptying and a shortened satiety period might contribute to development of obesity, this study compared gastric emptying of acaloric liquid, gastric acid production, and plasma levels of gastrin and pepsinogen I (PG I) and II (PG II) among obese and nonobese Pima Indians. Rates of fractional gastric emptying and of gastric acid secretion were similar in the two groups, basally and after an acaloric liquid meal. Basal and postprandial plasma gastrin levels did not differ significantly in obese and nonobese Pimas , but peak betazole-stimulated gastric acid output was greater in the obese group, except when normalized by body weight. The plasma PG I and PG II concentrations and PG I/PG II ratio did not differ significantly between the two groups, but the PG I/PG II ratio had a positive correlation with peak acid output. No correlation was found between fractional gastric emptying rate and degree of obesity. We conclude that an increased gastric emptying rate for liquid does not contribute to the pathogenesis of obesity in Pima Indians.

Adolescent↗
PubMed1986

Efficacy of gastric emptying: gastric lavage versus emesis induced with ipecac.

A prospective study was done to compare the efficacy of gastric emptying achieved by gastric lavage (GL) with that of ipecac-induced emesis (IE) in victims of drug overdose. Thiamine was used as a marker of recovery in gastric samples, as measured by ion exchange/ion pair high-performance liquid chromatography. There were 51 patients in the IE group and 37 in the GL group. GL produced a higher mean per cent recovery of thiamine than did IE (90% +/- 34% compared with 50% +/- 35%). There was a significant difference between the two groups (P less than .001). Recovery of thiamine was more than 70% in 28% of the IE patients, and exceeded 70% in 75% of GL patients. When gastric emptying is desired for management of the adult overdose victim, the use of GL maximizes the chance of recovering unabsorbed liquid drugs from the stomach.

Adult↗
PubMed1994

Partial gastric resection for peptic ulcer--comparison of the effect of variant reconstructive procedures on gastric emptying, gastric acid secretion and gastrin release in the early postoperative period II. Billroth-I gastroduodenostomy and comparison versus gastroenteroanastomotic procedures.

Gastric emptying (GE) of a radiolabelled solid meal, gastric acid secretion and gastrin release was measured before and/or by 91/2 weeks postoperatively in 12 patients with partial gastric resection supplied with Billroth-I gastroduodenoanastomosis and usually (n = 10) with truncal vagotomy [B-1+(VT))]. The results obtained were compared to those derived from another study involving 14 patients with partial gastric resection supplied with a gastroenterostomy (of Roux-en-Y type in 11, and Billroth-II type in 3 subjects) and truncal vagotomy [Roux(B-II)+VT]. The B-I+(VT) procedure affected significantly neither the overall GE (the median T1/2 was 75 min before and 95 min after the surgery) nor the GE pattern-the median curve shape parameter S was 0.73 before and 1.07 after the operation. The basal and pentagastrin-stimulated gastric acid secretion was reduced by an average of 79% (from 8.6 +/- 2.5 to 1.8 +/- 0.5 mmol h-1, p < 0.05) and 77% (from 22.0 +/- 2.8 to 5.0 +/- 1.5 mmol h-1, p < 0.05) after the B-I+(VT), respectively. Moreover, after the B-I+(VT) a decrease in the fasted serum gastric concentration (78.3 +/- 17.0 before vs 62.4 +/- 6.9 ng l-1 after the surgery) and in the postprandial gastrin release (AUC0-120: 11716 +/- 2482 ng l-1 min before vs 9753 +/- 1183 ng l-1 min after the surgery) was found; the relevant differences were, however, statistically not significant. In patients with a preoperatively normal GE, a markedly slowed GE (T1/2 above the limit of the mean T1/2 +2SD in healthy controls) was found in 5 out of 8 (62%) patients after the Roux-en-Y procedure, and only in 1 out of 7 (14%) patients after the B-I or B-II procedure. With regard to the postoperative data, the Roux (B-II)+VT resulted in lower gastric acid secretion and gastrin release than the B-I+(VT) procedure but the relevant differences were statistically not significant.

Adult↗
PubMed1993

Effect of highly selective vagotomy on gastric emptying, gastric acid secretion, and gastrin release: an early postoperative study in duodenal ulcer patients.

In 12 duodenal ulcer patients, gastric emptying (GE) of a radiolabelled solid meal, gastric acid secretion, and gastrin release were examined before and during the early postoperative period (median 13.5 days) after a highly selective vagotomy (HSV). HSV significantly delayed GE; the median slope of GE curves (K) decreased from 11.86 to 6.52 min-1 x 10(-3) (p < 0.01). A significant inhibition of the late phase of GE was reflected by a diminution of the curve shape parameter (S) from a median of 1.41 to 0.98 (p < 0.02). A profound impairment of GE after HSV was found in 4 of 12 patients (33%). HSV resulted in a 49% decrease in the basal acid output (6.9 +/- 1.0 before to 3.5 +/- 1.0 mmol.h-1 after HSV, and a 56% reduction in the pentagastrin-stimulated gastric acid secretion (31.1 +/- 5.1 before vs 13.8 +/- 2.4 mmol.h-1 after HSV (p < 0.01). A significant increase in both the fasted serum gastrin (38.9 +/- 3.7 to 66.9 +/- 8.4 ng.l-1, p < 0.05) and the meal-stimulated gastrin release (AUC0-120: 7179 +/- 440 to 11158 +/- 1062 ng.l-1 min, p < 0.05) was observed after HSV.

Adolescent↗
PubMed1994

Partial gastric resection for peptic ulcer--comparison of the effect of variant reconstructive procedures on gastric emptying, gastric acid secretion and gastrin release in the early postoperative period I. Roux-en-Y and Billroth-II gastroenteroanastomosis.

Fourteen patients subjected to partial gastric resection with vagotomy and a gastroenterostomy (Roux-en-Y, in 11 patients and of Billroth type-II in 3) underwent examinations of the gastric emptying (GE) of a radiolabelled solid meal, as well as of gastric acid and gastrin secretion before surgery and/or within 5.5 weeks postoperatively. The surgery resulted in a significant delay in GE-the median T1/2 nearly doubted from 77 min before to 151 min after the operation (p < 0.01). The GE pattern did not, however, change significantly, as reflected by a median curve shape parameter S amounting to 1.05 and 0.87 before and after the surgery, respectively. The Roux-en-Y reconstruction brought about a pronounced delay in GE with T1/2 exceeding the border of the mean T1/2 + 2SD of healthy controls in 7 (64%) out of 11 patients. On the other hand, no one of the B-II operated patients had a slowed GE. The basal and pentagastrin-stimulated gastric acid secretion was decreased by an average of 71% (from 6.2 +/- 0.7 to 1.8 +/- 0.6 mmol h-1, p < 0.001) and 82% (from 25.2 +/- 3.0 to 4.4 +/- 1.2 mmol h-1, p < 0.001), respectively. The surgery did not affect the fasting serum gastrin concentration (53.2 +/- 4.9 pre- vs 51.0 +/- 11.5 ng.l-1 postoperatively), whereas the postprandial gastrin release decreased significantly-AUC0-120: 9838 +/- 1377 ng.l-1 min before and 6863 +/- 1024 ng.l-1 min after the operation, p < 0.01.

Adult↗
PubMed1983

A central site of action for benzamide facilitation of gastric emptying.

Gastric emptying of the fed guinea-pig was measured using a non-invasive X-ray fluoroscopic technique to determine passage from the stomach of polystyrene-coated barium sulphate spheroids. Peripherally administered metoclopramide (0.1-10 mg/kg i.p.), clebopride (1-10 mg/kg i.p.), (-)-sulpiride (40 mg/kg i.p.), haloperidol (1 mg/kg i.p.) and domperidone (1-10 mg/kg i.p.) failed to modify gastric emptying. Stress inhibited emptying, and this was considered to explain the effects of eserine and high dose metoclopramide. Gastric emptying was decreased by peripherally administered atropine (0.5 mg/kg i.p.) and apomorphine (0.1-0.5 mg/kg s.c.); the apomorphine response was antagonised by pretreatment with haloperidol, domperidone, (-)-sulpiride, metoclopramide and clebopride but not by prazosin + propranolol. Gastric emptying was facilitated by intracerebroventricular (i.c.v.) administrations of metoclopramide and clebopride (40, 100 and 200 micrograms) but not by i.c.v. domperidone, haloperidol, fluphenazine or (-)-sulpiride (100, 200 micrograms) and was inhibited by i.c.v. apomorphine (100, 200 micrograms); the response to i.c.v. apomorphine was antagonised by i.c.v. pretreatments with haloperidol, domperidone, (-)-sulpiride, metoclopramide and clebopride (40-50 micrograms). Facilitation of emptying by i.c.v. metoclopramide was prevented by peripheral pretreatment with atropine (0.5 mg/kg i.p.). It is concluded that the actions of apomorphine and metoclopramide/clebopride to respectively inhibit and facilitate gastric emptying may be mediated, at least in part, via central mechanisms. Whilst apomorphine's action may be mediated via dopamine receptor mechanisms, metoclopramide and clebopride act at additional unspecified sites, metoclopramide's action being expressed via cholinergic mechanisms.

Animals↗
PubMed1992

Human gastric myoelectric activity and gastric emptying following gastric surgery and with pacing.

Postoperative gastric myoelectric activity, gastric emptying, and clinical course were correlated in 17 patients at high risk of developing gastroparesis after gastric surgery. In addition, an attempt was made to pace the stomach with an electrical stimulus and determine the effect of pacing on early postoperative gastric emptying. Gastric dysrhythmias (bradygastria, slow wave frequency < 2 cycles/min; tachygastria, slow wave frequency > 4 cycles/min) persisted beyond the first postoperative day in 6 patients (35%). Delayed gastric emptying was identified by a radionuclide meal in 15 patients (88%), but symptoms of gastroparesis developed in only 6 of 15 (40%). Patients with postoperative gastroparesis had more frequent dysrhythmias than asymptomatic patients (67% vs. 18%), but these differences were not significant, although we cannot exclude a type II statistical error. Gastric rhythm was entrained in 10 of 16 patients (63%). Pacing increased the gastric slow wave frequency (3.1 vs. 4.1 cycles/min; P < 0.01) but did not improve gastric emptying (gastric retention at 60 minutes, 86% +/- 6% for control and 90% +/- 2% for paced). In conclusion, gastric dysrhythmias do not appear to play a major role in the development of postsurgical gastroparesis. Although gastric rhythm could be entrained in the majority of patients, pacing did not improve gastric emptying overall.

Adult↗
PubMedDate not supplied

Effect of the menstrual cycle on gastric emptying.

Gastric emptying of a radiolabelled solid meal was studied in 19 women. The gastric emptying curves were analyzed with the use of a power-exponential fitting, and the results were related to the phases of the menstrual cycle. No significant differences between the phases of the menstrual cycle were found when the rates of gastric emptying were compared. However, different emptying patterns in each phase of menstrual cycle were revealed by the analysis of the curve shape parameter, S. The physiological and clinical relevance of the findings is discussed.

Adult↗
PubMed1986

[A study of gastric emptying in gastric and duodenal ulcers].

In the examination of gastric emptying using radioisotopic techniques, three areas of interest were established, i.e. the entire gastric, proximal gastric and antral area, and gastric emptying abnormalities in cases of gastric and duodenal ulcers and their mechanism were studied by analyzing gastric emptying curves obtained from these areas. Results were summerized as follows: In highly localized gastric ulcers at active stage, compared to healthy subjects, gastric emptying in the entire gastric area was accelerated, the movement of the contents from the proximal gastric area to the antral area was accelerated, and the movement from the proximal to the antral was greater than that from the antral to the duodenum during the first three minutes after start of the measurement. Hence, in highly localized gastric ulcers at active stage, it is believed that gastric emptying in the entire is accelerated as the movement from the proximal to the antral is accelerated. In low localized gastric ulcers at active stage, compared to healthy subjects, gastric emptying in the entire was not observed in the first minute and gastric emptying was delayed once it started, the movement from the proximal to the antral was fast as in healthy subjects in the first 17 minutes or so, and in the first seven minutes, the movement from the proximal to the antral was greater than that from the antral to the duodenum. Hence, in low localized gastric ulcers at active stage, it is believed that gastric emptying in the entire becomes delayed as the gastric emptying activity in the antral is lowered. In duodenal ulcers at active stage, compared to healthy subjects, gastric emptying in the entire was accelerated, the movement from the proximal to the antral was accelerated, and during the measurement, the movement from the antral to the duodenum was greater than that from the proximal to the antral. Hence, in duodenal ulcers at active stage, it is believed that gastric emptying in the entire is accelerated as gastric emptying ability of the entire becomes excited along with that in the proximal and antral. At healing stage, gastric emptying was found to be closer to that of healthy subjects than at active stage.

Adult↗
PubMed1987

Effect of the menstrual cycle on gastric emptying.

Gastric emptying of both solid- and liquid-phase markers was assessed in 7 normally-menstruating women who had undergone bilateral Fallopian tube ligations. The women were studied once during the follicular phase of their menstrual cycle and again during the luteal phase. Emptying of the liquid-phase marker was not significantly different during the two phases of the menstrual cycle. However, emptying of the solid-phase marker was significantly slower during the luteal phase of the cycle as compared to the follicular phase. This impairment of gastric emptying of solid was correlated with elevated serum levels of progesterone. This study demonstrates that the rate of gastric emptying of solids may vary with the phases of the menstrual cycle.

Adult↗
PubMed1989

Evaluation of the use of ultrasonography in the study of liquid gastric emptying.

Gastric emptying of two different test liquid meals (500 ml isotonic saline and 500 ml skimmed milk, 1.8% fat) has been measured in 10 (saline) and in 19 (milk) normal volunteers by means of real-time ultrasonography (RUS) and scintigraphy, employed simultaneously. In each subject, saline and milk contained 37 MBq of diethylenetriaminopentacetic acid (DPTA) marked with 99mTc. Determinations were made thereafter every 5 min up to 45 min with saline and every 30 min up to a maximum of 220 min with milk. The determination of gastric emptying by RUS was obtained indirectly through the measurement of gastric dimensions, with a single scan performed at the epigastrium, while the subject was kept in a standing position. At each observation, the percent decrease of gastric measurements and the decay in radioactivity over the gastric region were calculated, blind, by two independent examiners. Linear regression and correlation coefficient were subsequently computed for gastric measurements and decay in radioactivity. The results show that the values obtained with RUS do not differ grossly from the ones obtained with scintigraphy. This suggests that the ultrasonographic determination of gastric dimensions with a single section of the stomach may be a valuable method for use in the evaluation of gastric emptying of liquids.

Adult↗
PubMed1989

The effect of meal energy content on gastric emptying.

Gastric emptying (GE) has been reported to be influenced by meal weight (grams) and composition (% carbohydrate:protein:fat) but the effect of meal energy content (kcal) on gastric emptying, independent of composition, has not been thoroughly investigated by scintigraphic techniques. In order to determine the effect of caloric content on GE, 12 normal male volunteers, ranging in age from 19-28 yr (mean = 24 yr), had GE scans (n = 32) performed with a solid meal of fixed composition (carbohydrate 40%:protein 40%:fat 20%) but varying energy content [150 kcal (n = 9), 300 kcal (n = 14), and 600 kcal (n = 9)]. Increasing the energy content of the meal of fixed composition progressively delayed gastric emptying: T1/2 = 57', 70', and 95' for 150 kcal, 300 kcal and 600 kcal, respectively (p less than 0.05; Student's t-test). Reproducibility, evaluated by performing GE scans (n = 8) on different days in the same individual (n = 4) with the same meal (300 kcal), was good (r greater than or equal to 0.89). Variability varied inversely with meal energy content (CV:150 kcal greater than or equal to 300 kcal and 600 kcal). The 300 kcal mean seems to be the best compromise since it results in less intersubject variability than 150 kcal, has minimal intrasubject variability, but is not as prohibitively large as the 600 kcal meal.

Adult↗
PubMed1979

Factors influencing gastric emptying.

Gastric emptying time may be of investigative value and evidentiary significance in estimating the time of death. However, in order to express an expert opinion with a degree of certainty, the time, volume, and character of the last meal must be known, and other factors considered. The maximum normal emptying time for the healthy intact stomach is 6 h. Factors accelerating or delaying gastric emptying include fear and apprehension, acute and chronic diseases, trauma, drugs, and the stomach that has undergone surgery. Recognition of these influences supports the conclusions that the forensic pathologist draws regarding the interval between the last meal and death.

Adult↗
PubMed1979

Effect of long-term cimetidine on gastric acid secretion, serum gastrin, and gastric emptying.

Gastric acid secretion, gastric emptying, fasting serum gastrin and the serum gastrin response to a meal were measured in duodenal ulcer patients before, and at least five days after completing prolonged treatment with cimetidine (1 or 2 g/day for four or eight weeks followed by 600 mg twice daily for six months). Fasting serum gastrin and the gastrin response were also measured during treatment. Compared with pretreatment values, fasting serum gastrin concentrations were raised both during and five to 31 days after stopping treatment (P less than or equal to 0.02). The integrated gastrin response and the rate of gastric emptying of the solid component of the meal were increased during treatment (P less than 0.001 and P less than 0.002 respectively) but returned to pretreatment levels after stopping therapy. No significant changes were observed in the basal or maximal acid outputs or the rate of emptying of the liquid component of the meal. The results imply that the hypergastrinaemia associated with long-term cimetidine therapy does not result in increased gastric acid secretion.

Cimetidine↗