Cholinergic effects on human gastric motility

Parkman, Henry P.; Trate, Douglas M.; Knight, Linda C.; Brown, Kevin L.; Maurer, Alan H.; Fisher, Robert S.

doi:10.1136/gut.45.3.346

Cited by 99 publications

(76 citation statements)

References 18 publications

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“…Another feature of the gastric phase of digestion and antral distention is increased cholinergic input that increases the force of contractions that helps reduce the size of solid food particles in the distal stomach (e.g., refs. [30][31][32]. Stimulation of cholinergic neurons also can increase the frequency of slow waves in the gastric antrum (17).…”

Section: Discussionmentioning

confidence: 99%

Interstitial cells of Cajal mediate mechanosensitive responses in the stomach

Won

Sanders

Ward

2005

Proc. Natl. Acad. Sci. U.S.A.

151

141

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Changes in motor activity are a basic response to filling of smooth muscle organs. Responses to gastric filling, for example, are thought to be regulated by neural reflexes. Here, we demonstrate a previously uncharacterized aspect of stretch-dependent responses in visceral smooth muscles that is mediated by mechanosensitive interstitial cells of Cajal. Length ramps were applied to the murine antral muscles while recording intracellular electrical activity and isometric force. Stretching muscles by an average of 27 ؎ 1% of resting length resulted in 5 mN of force. Increasing length caused membrane depolarization and increased slow-wave frequency. The responses were dependent on the rate of stretch. Stretch-dependent responses were not inhibited by neuronal antagonists or nifedipine. Increases in slow-wave frequency, but not membrane depolarization, were inhibited by reducing external Ca 2؉ (100 M) and by Ni 2؉ (250 M). Responses to stretch were inhibited by indomethacin (1 M) and were absent in cyclooxygenase II-deficient mice, suggesting that cyclooxygenase II-derived eicosanoids may mediate these responses. Dual microelectrode impalements of muscle cells within the corpus and antrum showed that stretch-induced changes in slow-wave frequency uncoupled proximal-to-distal propagation of slow waves. This uncoupling could interfere with gastric peristalsis and impede gastric emptying. Stretch of antral muscles of W͞W V mice, which lack intramuscular interstitial cells of Cajal, did not affect membrane depolarization or slow-wave frequency. These data demonstrate a previously uncharacterized nonneural stretch reflex in gastric muscles and provide physiological evidence demonstrating a mechanosensitive role for interstitial cells of Cajal in smooth muscle tissues.gastric compliance ͉ pacemaker ͉ stretch ͉ slow waves ͉ propagation

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Section: Discussionmentioning

confidence: 99%

Interstitial cells of Cajal mediate mechanosensitive responses in the stomach

Won

Sanders

Ward

2005

Proc. Natl. Acad. Sci. U.S.A.

151

141

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“…Bethanechol is a cholinergic agonist used to activate the vagally mediated excitatory cholinergic pathway, and atropine has the opposite effect. Previous studies demonstrated that bethanechol accelerated and atropine slowed gastric emptying (37,40). Using these pharmacological agents, we confirmed the previous findings and showed significant changes in gastric emptying.…”

Section: Discussionmentioning

confidence: 99%

Electroacupuncture improves rectal distension-induced delay in solid gastric emptying in dogs

Yin

Chen

2011

American Journal of Physiology-Regulatory, Integrative and Comp

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Yin J, Chen JD. Electroacupuncture improves rectal distensioninduced delay in solid gastric emptying in dogs. Am J Physiol Regul Integr Comp Physiol 301: R465-R472, 2011. First published May 18, 2011 doi:10.1152/ajpregu.00271.2010.-The aim of this study was to investigate the effects and mechanisms of electroacupuncture (EA) on rectal distension (RD)-induced delay in solid gastric emptying in dogs. Gastric emptying of solids was assessed in 12 dogs chronically implanted with a duodenal cannula by collecting samples at different time points from the cannula and measuring the dried weights of the samples. Bethanechol and atropine were used to qualitatively validate the method. In separate experiments, gastric emptying of solids was measured in a number of sessions: control, RD, RD ϩ sham-EA, RD ϩ EA of 6 mA, RD ϩ EA of 3 mA, and RD ϩ EA ϩ naloxone. The method of gastric emptying by collecting and drying gastric chyme from the duodenal cannula was found to be accurate and reliable. Using the method, we found gastric emptying to be accelerated with bethanechol (70.01 Ϯ 8.10% vs. 82.61 Ϯ 4.15%, P ϭ 0.04, vs. control) and delayed with atropine (4.31 Ϯ 1.57%, P Ͻ 0.001, vs. control). RD substantially and significantly delayed gastric emptying. EA, but not sham-EA, attenuated delayed gastric emptying induced by RD (sham-EA: 48.79 Ϯ 9.47% vs. EA: 74.28 Ϯ 5.96%, P Ͻ 0.01). The effect was more potent with EA of 6 mA than EA of 3 mA and blocked by naloxone. EA is able to attenuate RD-induced delay in gastric emptying of solids, and this ameliorating effect may be mediated via the opioid pathway. EA may have a therapeutic potential for treating delayed gastric emptying attributed to lower gut distension. gastrointestinal motility; acupuncture; gastroparesis; constipation PATIENTS WITH CHRONIC, IDIOPATHIC, slow-transit constipation and constipation-dominant irritable bowel syndrome (IBS-C) frequently complain of upper abdominal symptoms, such as bloating, upper abdominal discomfort or pain, and vomiting. These symptoms are related to the presence of reduced motor activities attributed to impaired gastric antral contractions and myoelectrical activity, and delayed gastric emptying, as well as slow small bowel transit (1,3,14,38). The abnormality of upper gastrointestinal motility may be related to fecal stasis in the rectum or colon, causing reflexive inhibition (5,11,20,54). Rectal (balloon) distension (RD) mimicking fecal or gas stasis in the colorectal region is one of constipation models commonly used in the study of upper gastrointestinal motor activity. A number of studies have reported that RD impairs gastric myoelectrical activities, gastric tone, and gastric accommodation; reduces antral contractions; delays gastric emptying, and inhibits small-intestine motility in dogs and humans (1,2,7,11,21,39,54).Clinically, there are overlapping symptoms between functional dyspepsia and IBS-C (12, 44). Currently, there is a lack of effective medications for treating both upper and lower gastrointestinal symptoms. Acupuncture i...

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“…Increased gastric motility in the fasting state is associated with decreases in dominant frequency (Daniel 2001;Parkman et al 1999), and the welldocumented postprandial dip in frequency shortly after eating also is of vagal origin (Kaneko et al 1995). In contrast, the inhibition of cholinergic activity with atropine or vagotomy increases the pacemaker frequency in dogs and humans (Sarna and Daniel 1974;Stoddard et al 1981;Parkman et al 1999). Thus, gastric contractions get longer when vagal outflow to the stomach is enhanced and shorter when vagal outflow is reduced.…”

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confidence: 97%

Placebo Responses on Cardiovascular, Gastrointestinal, and Respiratory Organ Functions

Meißner

2014

Placebo

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It is widely acknowledged that placebo responses are accompanied by physiological changes in the central nervous system, but little is known about placebo responses on end organ functions. The present chapter aims to fill this gap by reviewing the literature on peripheral placebo responses. Overall, there is a wide range of placebo and nocebo responses on various organ functions of the cardiovascular, the gastrointestinal system, and the respiratory system. Most of these studies used expectation paradigms to elicit placebo and nocebo responses. Expectations can affect heart rate, blood pressure, coronary diameter, gastric motility, bowel motility, and lung function. Classical conditioning can induce placebo respiratory depression after prior exposure to opioid drugs, and habitual coffee drinkers show physiological arousal in response to coffee-associated stimuli. Similar to findings in placebo pain research, peripheral placebo responses can be target specific. The autonomic nervous system is a likely candidate to mediate peripheral placebo responses. Further studies are necessary to identify the brain mechanisms and pathways involved in peripheral placebo responses.

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Cholinergic effects on human gastric motility

Cited by 99 publications

References 18 publications

Interstitial cells of Cajal mediate mechanosensitive responses in the stomach

Interstitial cells of Cajal mediate mechanosensitive responses in the stomach

Electroacupuncture improves rectal distension-induced delay in solid gastric emptying in dogs

Placebo Responses on Cardiovascular, Gastrointestinal, and Respiratory Organ Functions

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