Distal stomach appears essential in the regulation of gastrointestinal transit

Abstract

Stomach and small bowel both influence gastrointestinal motility. We studied which portion of the stomach was essential for the regulation of gastrointestinal movement and determined the role of vasoactive intestinal polypeptide in this regulation. The study subjects consisted of 45 controls, 46 patients after subtotal gastrectomy, and 13 patients after total gastrectomy for stomach cancer. Orocecal transit time was measured, using the hydrogen breath test, to represent gastrointestinal movement, while plasma vasoactive intestinal polypeptide level was simultaneously assessed. The orocecal transit times in the study groups were (means +/- SD) 91.1 +/- 45.0, 57.1 +/- 34.3, and 60.8 +/- 34.8 min, respectively (P < 0.01). In the subtotal gastrectomy patients, age showed a negative correlation with orocecal transit time (r = -0.388; P < 0.01). In the total gastrectomy patients, no particular demographic factor influenced orocecal transit. Plasma vasoactive intestinal polypeptide levels in the three groups were 20.7 +/- 10.8, 22.7 +/- 10.9, and 20.6 +/- 9.1 pg/ml, respectively (NS). We conclude that both types of gastrectomies enhanced gastrointestinal movement, showing a similar effect, and that the distal stomach plus pylorus are most likely to exert an important inhibitory mechanism in the regulation of this movement. Vasoactive intestinal polypeptide is not a major peptide mediating this regulation.

Dissolution testing of oral modified-release dosage forms

“…As discussed before, the fed stomach empties only liquids and finely suspended particulate solids and the gastric‐emptying rate is determined by various factors, e.g. the size, the composition and the caloric load of the co‐administered meal, the osmolality of the gastric contents and the size and the density of the particles [42,43] . Large non‐disintegrating dosage forms typically remain in the stomach until digestion is complete and the interdigestive MMC reappears to be then emptied with the first final MMC phase III, [13,36] therefore, depending on the size and composition of the co‐administered meal, gastric residence of monolithic dosage forms can be in the range of several hours.…”