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.
SUMMARY The effects of rectal distension on upper gastrointestinal motility were investigated in six healthy subjects. On a control day, gastric and duodenal motor activity was recorded for nine hours of fasting and for four hours after a meal, duodeno-caecal transit being assessed in both interdigestive and digestive states. Motor activity and transit were also measured on a test day during which the rectum was distended for one hour during fasting and for one hour postprandially. Control and test days were randomised. During fasting, rectal distension increased the incidence of migrating motor complexes (0-8±0O3 v 0-5+±02 h-'; p<0-01) and reduced the duodenal phase 2 motility index to 66±45% of that observed on the control day (p<0O01). Further, duodeno-caecal transit time was increased by rectal distension (99±30 v 71±35 min; p<0.05). Postprandially, the period of rectal distension was marked by a reduction in the duodenal motility index to 24±13% of that observed during the comparable period on the control day (p<0-001) and a concomitant increase in duodeno-caecal transit time (113±22 v 80+17 min; p<0-01). We conclude that upper gastrointestinal motor activity, the effector of luminal transit, may be profoundly influenced by stimulation of distal afferents.In the investigation of patients with functional bowel disorders, disturbances of upper gastrointestinal motility have been shown in association with colorectal dysfunction as manifested by altered patterns of defecation. "-Although this may reflect a widespread disorder of gastrointestinal smooth muscle, inappropriate activation of enteroenteric reflexes4 may also occur. Early animal studies showed that gastric7 and small intestinal motor activity67 could be inhibited by rectal distension, the rapidity of the response suggesting a predominantly neural mechanism. More recent studies confirm these findings and suggest that both splanchnic and vagal components participate in this reflex.'In man, different patterns of gastric and small intestinal motor activity occur during the interdigestive and digestive states.9 Throughout fasting, a period of intense regular contractile activity recurs
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