Effect of cisapride on myoelectrical and motor responses of antropyloroduodenal region during intraduodenal lipid and antral tachygastria in conscious dog

Abstract

The myoelectrical and motor response of the antropyloroduodenal region to intraduodenal nutrient stimulation or antral tachygastria represent useful models for, respectively, physiological and pathophysiological gastric stasis to test the efficacy of prokinetic drugs. We evaluated the effects of an intravenous bolus of cisapride (0.63 mg/kg) on the myoelectrical and motor response of the antropyloroduodenal region to an intraduodenal triglyceride emulsion (10% Intralipid, 0.5 ml/min) or antral tachygastria in conscious dogs. Intraduodenal lipid suppressed antral motility (P < 0.05, compared to intraduodenal saline) and stimulated phasic pyloric contractions (P < 0.01, compared to intraduodenal saline), a motor pattern known to be associated with delayed gastric emptying. During intraduodenal lipid stimulation cisapride virtually abolished all isolated pyloric motor events (P < 0.05) and stimulated antral and duodenal motility (P < 0.05 for both) and antropyloroduodenal coordination (65% versus 15%; P < 0.05). Antral tachygastria was associated with a higher number of isolated pyloric motor events in the fasted state [0.8 (0.7-1.1) per minute versus 0.2 (0-0.3) per minute; P < 0.05], but not during intraduodenal lipid stimulation [1.1 (0.9-1.7) per minute versus 1.2 (1.0-1.9) per minute; NS]. Cisapride decreased the number and duration of spontaneous episodes of antral tachygastria during intraduodenal saline and lipid infusion (P < 0.05 for both) and abolished the tachygastria-associated motor patterns. Cisapride induced a 20% decrease in the antral slow-wave frequency during intraduodenal saline and lipid, irrespective of gastric pacemaker rhythm. We conclude that: (1) cisapride overcomes feedback from small intestinal lipid receptors on myoelectrical and motor activities of the antropyloroduodenal region and decreases antral slow-wave frequency, and (2) cisapride inhibits antral tachygastria and tachygastria-associated motor patterns. These effects may contribute to the effective gastrokinetic properties of cisapride in physiological and certain forms of pathophysiological gastric stasis.

Gastric Electrical Activity and Gastrointestinal Hormones in Dyspeptic Patients

“…Some authors have suggested that alterations in gastric electrical activity may be an accidental finding among other abnormalities in gastric electrical and mechanical activity. Others have demonstrated a correlation between tachygastria and the absence of antral motility [25], between tachyarrhythmia and the increased plasma vasopressin, epinephrine and nausea scores [26]. Furthermore, removal of an arrhythmogenic gastric focus led to clinical improvement [27].…”

Role of Serotonin in the Recovery of Electrical Activity in the Stomach and Small Intestine of Rats during the Early Postsurgery Period

“…The prokinetic action of cisapride is associated with its antagonistic activity relative to 5-HT 4 receptors [2,4,5]. Previous studies showed that treatment of the mucosa with selective 5-HT 4 receptor agonists triggers the peristaltic reflex in the intestine of humans, rats, and guinea pigs [5].…”

Gastric myoelectrical activity abnormalities of electrogastrography in patients with functional dyspepsia

“…Also, increased sensitivity to gastric distention due to visceral hyperalgesia plays a role in the development of these symptoms (26). On the other hand, animal studies have shown that tachygastria, an important factor leading to FD, develops in the absence of antral motility (27), and is correlated with levels of vasopressin and epinephrine and the quantitative nausea score (9,14). (6).…”