Assessment by prolonged ambulatory manometry of the effect of oral cisapride on proximal small bowel inter-digestive motility

Benson, Martin; Castillo, Fortunato D.; Deeks, Jonathan J; Wingate, David

doi:10.1007/bf01296504

Cited by 22 publications

(17 citation statements)

References 22 publications

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“…*P < 0.05 compared with control period. , while cisapride, also a 5-HT4-receptor agonist, given orally or parenterally to healthy volunteers, did not induce phase I11 activity or increase its propagation velocity [28,29]. Possible explanations for the disparate results obtained in dogs and man are species differences as well as differences between the two compounds renzapride and cisapride.…”

Section: Plasma Concentration (Nmol/l) Of Lht During Infusion Of Lht mentioning

confidence: 95%

Concentration-Dependent Stimulation of Intestinal Phase III of Migrating Motor Complex by Circulating Serotonin in Humans

et al. 1998

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1. The influence of circulating 5-hydroxytryptamine (serotonin) on small intestinal motility was investigated in healthy volunteers. 2. Small intestinal motility was studied by means of a constantly perfused multi-channel manometry tube, connected to a computer system. 3. Intravenous infusions of either 5-hydroxytryptamine at increasing doses or saline were given over a period of 4 h. 4. 5-Hydroxytryptamine infusion dose-dependently increased plasma 5-hydroxytryptamine from approximately 2 to 10 and 25 nmol/l respectively, as well as urinary excretions of 5-hydroxytryptamine and 5-hydroxyindole acetic acid, a major 5-hydroxytryptamine metabolite. 5. The number of phase III of the migrating motor complex originating in the small intestine was dose-dependently increased by 5-hydroxytryptamine, and found to correlate to the plasma concentration of 5-hydroxytryptamine. The fraction of phase III also increased at the expense of phase II activity. In addition, 5-hydroxytryptamine increased the motility index, propagation velocity of phase III activity and the amplitude of contractions during phase III. 6. Whereas the low dose of 5-hydroxytryptamine (15 nmol.min-1.kg-1) had no haemodynamic effects, an increase in heart rate by approximately 20 beats/min, without change in blood pressure, was observed at the higher dose (60 nmol.min-1.kg-1). Respiratory parameters did not change during infusion of 5-hydroxytrytamine at either dose. 7. In conclusion, elevation of circulating 5-hydroxytryptamine by intravenous infusion results in more frequent and faster propagating migrating motor complexes in the human small intestine during the inter-digestive period.

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Section: Plasma Concentration (Nmol/l) Of Lht During Infusion Of Lht mentioning

confidence: 95%

Concentration-Dependent Stimulation of Intestinal Phase III of Migrating Motor Complex by Circulating Serotonin in Humans

et al. 1998

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“…56 Through application of the mixed effects model, an estimate for the effect of RH or NS patients over CS, its 95% confidence interval (CI), and its statistical significance were calculated. 57 In order to maintain normal distribution of residuals (random errors) in the mixed effects model, data for each RMC variable were first transformed logarithmically to derive a single summary statistic for each individual, and the expected effect and its 95% confidence interval from the model were then antilog transformed. Using this methodology, the estimated effect for a variable should be interpreted as relative change.…”

Section: Rmc Variablesmentioning

confidence: 99%

Rectal sensorimotor dysfunction in patients with urge faecal incontinence: evidence from prolonged manometric studies

Chan

2005

Gut

100

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Background and aims: Although external anal sphincter dysfunction is the major cause of urge faecal incontinence, approximately 50% of such patients have evidence of rectal hypersensitivity and report exaggerated stool frequency and urgency. The contribution of rectosigmoid contractile activity to the pathophysiology of this condition is unclear, and thus the relations between symptoms, rectal sensation, and rectosigmoid motor function were investigated. Methods: Fifty two consecutive patients with urge faecal incontinence, referred to a tertiary surgical centre, and 24 volunteers, underwent comprehensive anorectal physiological investigation, including prolonged rectosigmoid manometry. Patients were classified on the basis of balloon distension thresholds into those with rectal hypersensitivity (n = 27) and those with normal rectal sensation (n = 25). Automated quantitative analysis of overall rectosigmoid contractile activities and, specifically, high amplitude contractions and rectal motor complex activity was performed. Results: External anal sphincter dysfunction was similar in both patient groups. Overall, phasic activity and high amplitude contraction frequency were greater, and rectal motor complex variables significantly altered, in those with rectal hypersensitivity. Symptoms, more prevalent in the rectal hypersensitivity group, were also more often associated with rectosigmoid contractile events. For individuals, reduced compliance and increased rectal motor complex frequency were only observed in patients with rectal hypersensitivity. Conclusions: We have identified a subset of patients with urge faecal incontinence-namely, those with rectal hypersensitivity-who demonstrated increased symptoms, enhanced perception, reduced compliance, and exaggerated rectosigmoid motor activity. Comprehensive assessment of rectosigmoid sensorimotor function, in addition to evaluation of anal function, should be considered in the investigation of patients with urge faecal incontinence.

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“…Studies that have measured amplitudes of pressure waves have also shown an increase in amplitude as a result of cisapride treatment (9,11), or an increase in motility index (10), also likely to be a reflection of a higher amplitude of pressure waves. Two postprandial duodenal motility studies found no increase in number of pressure waves (11,13), as in the present study. One study in humans (12) found an increased incidence of jejunal contractions after a single dose of cisapride.…”

Section: -Omg Absorption and Cisapridementioning

confidence: 99%

Small Bowel Motility Affects Glucose Absorption in a Healthy Man

et al. 2002

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OBJECTIVE -To investigate the relationship between duodenojejunal motor activity and glucose absorption and to evaluate the effect of modification of duodenojejunal motility on glucose absorption by using the prokinetic drug cisapride.RESEARCH DESIGN AND METHODS -We examined seven healthy males, mean age 22 years, who were treated with cisapride 10 mg t.i.d. and placebo during 3 days in a randomized order, with a 2-week time interval. Duodenojejunal manometry was performed after each treatment on the morning of day 3, using an 18-lumen catheter. A liquid nutrient (3 kcal/min) was administered intraduodenally for 30 min, followed by a bolus of the glucose analog 3-Omethylglucose (3-OMG). Plasma 3-OMG concentrations were measured to assess absorption kinetics.RESULTS -The area under the 3-OMG concentration curve in the first 30 min after infusion was related to the number of antegrade propagated pressure waves (r ϭ 0.49, P Ͻ 0.05), but not to the peak concentration, time to peak, and absorption fraction. The mean amplitude of pressure waves was higher during cisapride than placebo (P Ͻ 0.05), but the reoccurrence of interdigestive motility, numbers of pressure waves, and propagated pressure waves, as well as 3-OMG absorption characteristics, were not significantly different between the two treatments. During both treatments Ͼ60% of antegrade propagated pressure waves were propagated over a very short distance (1.5 cm).CONCLUSIONS -Glucose absorption in the human small intestine is related to shorttraveling propagated intestinal contractile activity. Cisapride increases the amplitude of pressure waves, but does not affect the organization of pressure waves or the absorption of 3-OMG. Diabetes Care 25:1857-1861, 2002D igestion and absorption of nutrients are the primary functions of the small bowel. Small intestinal motor activity serves to facilitate exposure of luminal contents to the mucosal surface. Studies demonstrating the interactions between intestinal motility and nutrient absorption are few and have yielded conflicting results (1-5). This may be due to the fact that the interaction is complex and dependent on the organization of motor activity (i.e., propagated or nonpropagated) and is also affected by neuroendocrine factors.Recent studies have provided insights into the relationships between gastrointestinal motor function and glucose absorption, showing that variation in the rate of gastric emptying accounts for ϳ35% of the variance in peak blood glucose concentrations after ingestion of glucose, and that increased small intestinalpropagated activity results in the blunting of the postprandial glycemic peak (6).In the present study we used the prokinetic drug cisapride as a tool to modify small intestinal transit. Transit studies have shown the propulsive properties of cisapride in the small intestine (7,8) and its effects on fasting and postprandial gastrointestinal motility have been well established (9 -13).Several reports have shown that the spatiotemporal organization of pressure waves (i.e., propag...

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Assessment by prolonged ambulatory manometry of the effect of oral cisapride on proximal small bowel inter-digestive motility

Cited by 22 publications

References 22 publications

Concentration-Dependent Stimulation of Intestinal Phase III of Migrating Motor Complex by Circulating Serotonin in Humans

Concentration-Dependent Stimulation of Intestinal Phase III of Migrating Motor Complex by Circulating Serotonin in Humans

Rectal sensorimotor dysfunction in patients with urge faecal incontinence: evidence from prolonged manometric studies

Small Bowel Motility Affects Glucose Absorption in a Healthy Man

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