Development of a test to measure gastric accommodation in humans

Kuiken, Sjoerd D.; Samsom, Melvin; Camilleri, Michael; Mullan, Brian P.; Burton, Duane D.; Kost, Louis J.; Hardyman, Timothy J.; Brinkmann, Benjamin H.; O’Connor, Michael K.

doi:10.1152/ajpgi.1999.277.6.g1217

Cited by 115 publications

(179 citation statements)

References 27 publications

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“…Gastric volumes were assessed by single-photon-emission computed tomography (SPECT) as described previously (2,3,25). After intravenous injection of 99m Tc-labeled sodium pertechnetate (10 mCi), dynamic tomographic images of the gastric wall were acquired during fasting and for a total of 32 min after ingestion of a 300-ml nutrient drink (Ensure, 1 kcal/ml, Ross Laboratories, Abbott Park, IL) through a straw by a dual-head gamma camera (Helix SPECT System, Elscint, Haifa, Israel) in a multiorbit-mode system.…”

Section: M Tc-spect For Measuring Gastric Volume and Accommodationmentioning

confidence: 99%

Nitrergic contribution to gastric relaxation induced by glucagon-like peptide-1 (GLP-1) in healthy adults

Andrews

Bharucha²,

Camilleri³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

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Zinsmeister AR. Nitrergic contribution to gastric relaxation induced by glucagon-like peptide-1 (GLP-1) in healthy adults. Am J Physiol Gastrointest Liver Physiol 292: G1359 -G1365, 2007. First published February 8, 2007 doi:10.1152/ajpgi.00403.2006.-The incretin glucagon-like peptide-1 (GLP-1), which is used to treat diabetes mellitus, delays gastric emptying by inhibiting vagal activity. GLP-1 also increases fasting and postprandial gastric volume in humans. On the basis of animal studies, we hypothesized that nitric oxide mediates the effects of GLP-1 on gastric volumes. To assess the effects of nitrergic blockade on GLP-1-induced gastric accommodation in humans, in this double-blind study, 31 healthy volunteers were randomized to placebo (i.e., saline), GLP-1, or the nitric oxidealone or with GLP-1. Thereafter, 16 additional subjects were randomized to GLP-1 alone or together with a higher dose of L-NMMA (10 mg/kg bolus plus 8 mg ⅐ kg Ϫ1 ⅐ h Ϫ1 infusion). Gastric volumes (fasting pre-and postdrug, postprandial postdrug) were measured by 99m Tc-single-photon-emission computed tomography imaging. GLP-1 increased (P ϭ 0.04) fasting gastric volume by 83 Ϯ 16 ml (vs. 17 Ϯ 11 ml for placebo) and augmented (P Յ 0.01) postprandial accommodation by 688 Ϯ 165 ml (vs. 542 Ϯ 29 ml for placebo). L-NMMA (low dose) alone did not affect fasting or postprandial gastric volume. L-NMMA (low dose) did not attenuate the effect of GLP-1 on gastric volumes. In contrast, L-NMMA (high dose) did not affect fasting volume but blunted GLP-1-mediated postprandial accommodation (postprandial change ϭ 494 Ϯ 37 ml, P Յ 0.01 vs. GLP-1 alone). These data are consistent with the hypothesis that nitric oxide partly mediates the effects of GLP-1 on postprandial but not fasting gastric volumes in humans. accommodation; stomach; postprandial; diabetes; vagus GLUCAGON-LIKE PEPTIDE-1 (GLP-1) is an incretin produced by enteroendocrine L cells throughout the small intestine (45). The GLP-1 agonist exendin-4 improves glycemic control in patients with Type 2 diabetes mellitus inadequately treated with oral hypoglycemic agents (20). GLP-1 reduces postprandial glycemia not only by its hormonal effects (i.e., reduced glucagon and increased insulin release) (20, 29), but also by its powerful effects on gastrointestinal (GI) motility and secretion (31). Thus GLP-1 is a mediator of the ileal brake, delays gastric emptying, increases gastric volume, and reduces gastric acid secretion in humans (8,40,41). These GI effects of GLP-1 may also contribute to its side effects at pharmacological concentrations. For example, in a multicenter study of 551 patients with inadequately controlled Type 2 diabetes mellitus, 57% of patients treated with a GLP-1 agonist reported nausea and 17% reported vomiting, and GLP-1 was discontinued because of these side effects in 6% of patients (18).An intact vagus nerve is necessary for GLP-1 to delay gastric emptying in rats and pigs (21, 48) and to inhibit acid secretion in humans (49). GLP-1 also inhibits the plasma pancreatic pol...

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Section: M Tc-spect For Measuring Gastric Volume and Accommodationmentioning

confidence: 99%

Nitrergic contribution to gastric relaxation induced by glucagon-like peptide-1 (GLP-1) in healthy adults

Andrews

Bharucha²,

Camilleri³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…In 1999, single photon emission computed tomography (SPECT) was introduced as a non-invasive method to measure fasting and postprandial gastric volume. 13 The method used includes a semiautomated segmentation algorithm to identify the intra-abdominal organ with the highest uptake of 99m Tc. In order to understand further the pathophysiology of upper gastrointestinal disorders, a method to simultaneously measure gastric volume and emptying via SPECT was developed and validated.…”

Section: Measurement Of Gastric Volume and Emptyingmentioning

confidence: 99%

“…for 2 days, participants presented to the General Clinical Research Center in the fasted state for gastric emptying and volume measurements using previously validated methods. 13,[17][18][19] After study personnel confirmed that the participant was fasting (8 h) and had taken four doses of the study medication in the prior 2 days, 10 mCi of 99m Tc-pertechnate was injected intravenously. Ten minutes later, a gastric image was obtained with SPECT while the participant was still fasting.…”

Section: Study Proceduresmentioning

confidence: 99%

“…Thus, prior to the study, and based on a two-tailed, unpaired t-test, there was 80% power to detect the following effect sizes in response to treatment: 23% difference in postprandial gastric volume, 54% difference in fasting gastric volume and 48% difference in gastric emptying based on the results in prior studies in healthy human subjects in our laboratory using the same methods. 13,[17][18][19] After the study, we analysed the sample size required to demonstrate a significant effect based on the pooled variance and differences in mean gastric emptying at 4 h and change in gastric volume after the meal.…”

Section: Statistical Analysis and Powermentioning

confidence: 99%

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Effect of a proton pump inhibitor on postprandial gastric volume, emptying and symptoms in healthy human subjects: a pilot study

Grudell

Camilleri

Burton

et al. 2006

Aliment Pharmacol Ther

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“…Three-dimensional SPECT volumetric imaging of the outer wall of the stomach can then be performed. SPECT has been validated as a noninvasive method to measure gastric volume (64,65). It is also possible to simultaneously assess the relationship of liquid-or solidmeal emptying and gastric accommodation.…”

Section: Fundal Accommodation and Intragastric Distribution Studiesmentioning

confidence: 99%

Gastrointestinal Motility, Part 1: Esophageal Transit and Gastric Emptying

Maurer

2016

J. Nucl. Med. Technol.

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CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than March 2019. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test.Although not as well standardized as gastric emptying (GE) scintigraphy, esophageal transit scintigraphy, if performed in a comprehensive manner including both quantitative and qualitative analysis of single-and multiple-swallow studies, is clinically useful when expertise in esophageal manometry is not available or not tolerated and when esophageal manometry or barium videofluoroscopy results are equivocal or nondiagnostic. GE scintigraphy has undergone much-needed standardization. Both solid and liquid GE studies play an important role in assessing patients with upper gastrointestinal symptoms. Because measurement of simple total GE is often not sufficient to explain patient symptoms, there is a need to expand the analysis of GE scintigraphy to include the separate roles of the fundus and antrum and to include the complex interactions the stomach has with other organ systems.

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Development of a test to measure gastric accommodation in humans

Cited by 115 publications

References 27 publications

Nitrergic contribution to gastric relaxation induced by glucagon-like peptide-1 (GLP-1) in healthy adults

Nitrergic contribution to gastric relaxation induced by glucagon-like peptide-1 (GLP-1) in healthy adults

Effect of a proton pump inhibitor on postprandial gastric volume, emptying and symptoms in healthy human subjects: a pilot study

Gastrointestinal Motility, Part 1: Esophageal Transit and Gastric Emptying

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