Duodenal motility during a run–bike–run protocol: the effect of a sports drink

Hp, Peters; Wr, de Vries; Lm, Akkermans; Gp, van Berge-Henegouwen; Koerselman, Jeroen; Jw, Wiersma; E, Bol; Wl, Mosterd

doi:10.1097/00042737-200210000-00014

Cited by 12 publications

(5 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hence, both the occurrence and characteristics of phase 3 activity appear to have a strong influence on GE in the critically ill. There is little information regarding MMC activity in other disease states 30,31 …”

Section: Discussionmentioning

confidence: 99%

“…There is little information regarding MMC activity in other disease states. 30,31 Previous reports in the critically ill describe major abnormalities in motility in the proximal and distal stomach, and the pylorus and suggest that the frequency of duodenal motor activity is relatively normal. 8,16,32 Increased pyloric activity has been associated with reduced GE in this group.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gastric emptying and the organization of antro‐duodenal pressures in the critically ill

Chapman

Fraser

Bryant

et al. 2007

Neurogastroenterology Motil

View full text Add to dashboard Cite

The motor dysfunctions underlying delayed gastric emptying (GE) in critical illness are poorly defined. Our aim was to characterize the relationship between antro-duodenal (AD) motility and GE in critically ill patients. AD pressures were recorded in 15 mechanically ventilated patients and 10 healthy volunteers for 2 h (i) during fasting, (ii) following an intragastric nutrient bolus with concurrent assessment of GE using the (13)C-octanoate breath test and (iii) during duodenal nutrient infusion. Propagated waves were characterized by length and direction of migration. Critical illness was associated with: (i) slower GE (GEC: 3.47 +/- 0.1 vs 2.99 +/- 0.2; P = 0.046), (ii) fewer antegrade (duodenal: 44%vs 83%, AD: 16%vs 83%; P < 0.001) and more retrograde (duodenal: 46%vs 12%, AD: 38%vs 4%; P < 0.001) waves, (iii) shorter wave propagation (duodenal: 4.7 +/- 0.3 vs 6.0 +/- 0.4 cm; AD: 7.7 +/- 0.6 vs 10.9 +/- 0.9 cm; P = 0.004) and (iv) a close correlation between GE with the percentage of propagated phase 3 waves that were antegrade (r = 0.914, P = 0.03) and retrograde (r = -0.95, P = 0.014). In critical illness, the organization of AD pressure waves is abnormal and associated with slow GE.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gastric emptying and the organization of antro‐duodenal pressures in the critically ill

Chapman

Fraser

Bryant

et al. 2007

Neurogastroenterology Motil

View full text Add to dashboard Cite

show abstract

“…Decreased splanchnic blood flow with maximal exercise is believed to play a role in delayed gastric emptying, thereby promoting GER (37). The mode of exercise exerts some effect as running decreases motility (duodenal) more than cycling (36). This leads to decreased clearance of esophageal contents and impairment of the protective effect of esophageal contraction in maintaining LES pressure.…”

Section: Gastroesophageal Reflux Diseasementioning

confidence: 99%

Upper Gastrointestinal Issues in Athletes

Waterman

Kapur

2012

Current Sports Medicine Reports

View full text Add to dashboard Cite

Gastrointestinal (GI) complaints are common among athletes with rates in the range of 30% to 70%. Both the intensity of sport and the type of sporting activity have been shown to be contributing factors in the development of GI symptoms. Three important factors have been postulated as contributing to the pathophysiology of GI complaints in athletes: mechanical forces, altered GI blood flow, and neuroendocrine changes. As a result of those factors, gastroesophageal reflux disease (GERD), nausea, vomiting, gastritis, peptic ulcers, GI bleeding, or exercise-related transient abdominal pain (ETAP) may develop. GERD may be treated with changes in eating habits, lifestyle modifications, and training modifications. Nausea and vomiting may respond to simple training modifications, including no solid food 3 hours prior to an athletic event. Mechanical trauma, decreased splanchnic blood flow during exercise, and non-steroidal anti-inflammatory drugs (NSAID) contribute to gastritis, GI bleeding, and ulcer formation in athletes. Acid suppression with proton-pump inhibitors may be useful in athletes with persistence of any of the above symptoms. ETAP is a common, poorly-understood, self-limited acute abdominal pain which is difficult to treat. ETAP incidence increases in athletes beginning a new exercise program or increasing the intensity of their current exercise program. ETAP may respond to changes in breathing patterns or may resolve simply with continued training. Evaluation of the athlete with upper GI symptoms requires a thorough history, a detailed training log, a focused physical examination aimed at ruling out potentially serious causes of symptoms, and follow-up laboratory testing based on concerning physical examination findings.

show abstract

“…The intragastric pressure may rise due to contraction of abdominal musculature and by ingestion of fluid and food, whereas carbohydrate containing beverage may induce transient lower oesophageal sphincter relaxation. Aerophagia that often accompanies tachypnea during exercise may aggravate upper GI‐symptoms . Furthermore, hyperosmolar carbohydrate sport drinks delayed gastric emptying time in some well‐designed studies in athletes .…”

Section: Clinical Presentation and Management Of Exercise‐induced Gasmentioning

confidence: 99%

Review article: the pathophysiology and management of gastrointestinal symptoms during physical exercise, and the role of splanchnic blood flow

Steege

Kolkman

2012

Aliment Pharmacol Ther

104

View full text Add to dashboard Cite

Summary Background The prevalence of exercise‐induced gastrointestinal (GI) symptoms has been reported up to 70%. The pathophysiology largely remains unknown. Aim To review the physiological and pathophysiological changes of the GI‐tract during physical exercise and the management of the most common gastrointestinal symptoms. Methods Search of the literature published in the English and Dutch languages using the Pubmed database to review the literature that focused on the relation between splanchnic blood flow (SBF), development of ischaemia, postischaemic endotoxinemia and motility. Results During physical exercise, the increased activity of the sympathetic nervous system (SNS) redistributes blood flow from the splanchnic organs to the working muscles. With prolonged duration and/or intensity, the SBF may be decreased by 80% or more. Most studies point in the direction of increased SNS‐activity as central driving force for reduction in SBF. A severely reduced SBF may frequently cause GI ischaemia. GI‐ischaemia combined with reduced vagal activity probably triggers changes in GI‐motility and GI absorption derangements. GI‐symptoms during physical exercise may be prevented by lowering the exercise intensity, preventing dehydration and avoiding the ingestion of hypertonic fluids. Conclusions Literature on the pathophysiology of exercise‐induced GI‐symptoms is scarce. Increased sympathetic nervous system activity and decreased splanchnic blood flow during physical exercise seems to be the key factor in the pathogenesis of exercise‐induced GI‐symptoms, and this should be the target for symptom reduction.

show abstract

Duodenal motility during a run–bike–run protocol: the effect of a sports drink

Abstract: Prolonged exercise results in gastrointestinal symptoms and a significant interruption of postprandial motility. Only the latter phenomenon depends on the mode of exercise and supplementation.

Cited by 12 publications

References 22 publications

Gastric emptying and the organization of antro‐duodenal pressures in the critically ill

Gastric emptying and the organization of antro‐duodenal pressures in the critically ill

Upper Gastrointestinal Issues in Athletes

Review article: the pathophysiology and management of gastrointestinal symptoms during physical exercise, and the role of splanchnic blood flow

Contact Info

Product

Resources

About