Decreased gastric emptying and gastrointestinal and intestinal transits of liquid after complete spinal cord transection in awake rats

Abstract

We studied the effect of complete spinal cord transection (SCT) on gastric emptying (GE) and on gastrointestinal (GI) and intestinal transits of liquid in awake rats using the phenol red method. Male Wistar rats (N = 65) weighing 180-200 g were fasted for 24 h and complete SCT was performed between C 7 and T 1 vertebrae after a careful midline dorsal incision. GE and GI and intestinal transits were measured 15 min, 6 h or 24 h after recovery from anesthesia. A test meal (0.5 mg/ml phenol red in 5% glucose solution) was administered intragastrically (1.5 ml) and the animals were sacrificed by an iv thiopental overdose 10 min later to evaluate GE and GI transit. For intestinal transit measurements, 1 ml of the test meal was administered into the proximal duodenum through a cannula inserted into a gastric fistula. GE was inhibited (P<0.05) by 34.3, 23.4 and 22.7%, respectively, at 15 min, 6 h and 24 h after SCT. GI transit was inhibited (P<0.05) by 42.5, 19.8 and 18.4%, respectively, at 15 min, 6 h and 24 h after SCT. Intestinal transit was also inhibited (P<0.05) by 48.8, 47.2 and 40.1%, respectively, at 15 min, 6 h and 24 h after SCT. Mean arterial pressure was significantly decreased (P<0.05) by 48.5, 46.8 and 41.5%, respectively, at 15 min, 6 h and 24 h after SCT. In summary, our report describes a decreased GE and GI and intestinal transits in awake rats within the first 24 h after high SCT.

Time‐course of recovery of gastric emptying and motility in rats with experimental spinal cord injury

“…Selective alterations in small bowel transit, ileal fluid and electrolyte transport have been reported after SCI 37,38 . Enhanced intestinointestinal inhibitory reflexes have been proposed as one factor leading to reduced gastric emptying 39 .…”

“…With the [ 13 C]‐octanoic acid breath test technique, we identified a rapid reduction in fractional [ 13 C] recovery that we infer represents the diminished emptying of the solid test meal. Understanding the mechanisms responsible for delayed gastric emptying may serve to explain the long‐term alterations in nutritional state observed in previous studies, 12 as will identifying the consequences of altered fluid and electrolyte transport, 37 impaired small bowel transit 38 and absorptive capacity of the GI tract. Such insights will be essential for the maintenance of proper energy balance appropriate to the neurotrauma patient.…”

Upper gastrointestinal motility changes following spinal cord injury

“…Gondim et al. first reported that in rats the GE, intestinal and GI transit of liquid were delayed after the resolution of the spinal shock phase (1 day after C7‐T1 SCT) 10 . The authors extended their observations throughout the subacute phase (7‐day period), and observed that the GE and GI transit of liquid were delayed 3 and 7 days after SCT between C7 and T1 or between T4 and T5 12 .…”

“…Gondim et al. 10 were the first to observe that during the first day after complete SCT between C7 and T1 (15 min and 6 h after anaesthesia recovery), the GE, and the intestinal and GI transit of liquid are delayed in rats. In these experiments, the authors used the phenol red dye recovery technique to evaluate GE, intestinal and GI transit of liquid, 10 min after test meal administration.…”

The effect of spinal cord injury on vagal afferents.

“…Gastrointestinal (GI) alterations after human upper-thoracic SCI include conditions such as dysphagia (Wolf and Meiners, 2003), esophagitis (Stinneford et al, 1993), peptic ulcerations (Tanaka et al, 1979, Gore et al, 1981, gastroparesis and overall dysmotility (Rajendran et al, 1992, Stinneford et al, 1993, Segal et al, 1995, De Looze et al, 1998, Kao et al, 1999, Williams et al, 2012. Although the mechanisms of GI dysfunction in humans after SCI are not thoroughly understood, experimental 50 studies in rats suggest that many of the delays in gastric emptying and transit may in part be attributed to vagally-mediated pathways (Gondim et al, 1998, Gondim et al, 1999, Gondim et al, 2001, Tong and Holmes, 2009, Holmes, 2012. In fact, subdiaphragmatic vagotomy has been shown to prevent much of the SCI-induced GI sequelae (Gondim et al, 2001).…”