Effects of Fractionated Abdominal Irradiation on Small Intestinal Motility<i>Studies in a Novel In Vitro Animal Model</i>

Fraser, Robert; Frisby, Claudine L.; Schirmer, M; Blackshaw, Ashley; Langman, Jenifer M.; Yeoh, Eric; Rowland, R.; Horowitz, Michael

doi:10.3109/02841869709001341

Cited by 12 publications

(10 citation statements)

References 22 publications

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“…Las lesiones agudas suelen deberse al daño epitelial (9), los trastornos motores originados por la irritación neural y otras anomalías provocadas por la radiación (10,11). La sintomatología suele aparecer a los pocos días o semanas de la exposición.…”

Section: Discussionunclassified

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Obscure gastrointestinal bleeding: a complication of radiation enteritis diagnosed by wireless capsule endoscopy

Ares

Conde

Ruzo

et al. 2004

Rev. esp. enferm. dig.

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Obscure gastrointestinal bleeding is a common disorder and may account for as many as 5% of all gastrointestinal hemorrhages. It is often caused by lesions in the small intestine, which were very complicated to examine prior to the advent of wireless capsule endoscopy.Here we present the case of a 31-year-old woman with obscure gastrointestinal bleeding as a complication of radiation enteritis, which was diagnosed only after she underwent an examination with wireless capsule endoscopy.This technique has proven to be far superior to other radiographic and endoscopic methods in diagnosing obscure gastrointestinal bleeding and pathologies of the small intestine in general.

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Section: Discussionunclassified

“…Acute lesions are usually due to damage to the epithelium (9), motor disorders from neural irritation, and other anomalies caused by radiation (10,11). Symptoms usually occur a few days or weeks after exposure.…”

Section: Discussionmentioning

confidence: 99%

Obscure gastrointestinal bleeding: a complication of radiation enteritis diagnosed by wireless capsule endoscopy

Ares

Conde

Ruzo

et al. 2004

Rev. esp. enferm. dig.

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“…In vitro ileal pressure recordings from a ferret after fractionated irradiation showed an initial increase in frequency followed by a non-significant reduction in the frequency, but not the amplitude of contractions [61] . The frequency of pressure waves showed an inverse relationship with time after radiation with no relationship between motility and histology.…”

Section: Giant Migrating Contractionsmentioning

confidence: 99%

Effects of radiation upon gastrointestinal motility

Otterson¹

2007

WJG

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neural and chemical control. Myogenic control refers to the electrical activity generated by the smooth muscle of the gut. Electrical control activity (ECA) [1][2][3][4] is the omnipresent rhythmic depolarization of the cell membranes of the smooth muscle of the small intestine. With neural or chemical stimulation, membrane depolarization exceeds an excitation threshold and a contraction results. The electrical correlate of a contraction is called electrical response activity (ERA) [1][2][3][4] . These bursts of electrical response activity have a 1:1 relationship with contractions. Because ERA occurs only during the depolarization phase of the ECA cycle, the frequency of contractions is limited to and determined by the frequency of ECA. Neural and chemical stimulation may not be present during each depolarization of ECA, and thus contractions then do not occur at the maximum possible frequency (Figure 1). Recordings of gastrointestinal motility can either be made with devices that record physical contractions (manometry catheter or strain gauges) or motility can be implied from electrical activity or transit times.Single dose (938 Gy) in a canine model disrupted normal electrical patterns [5] . Jejunal myoelectric activity decreased in frequency, duration and length of migration o f E R A p o s t p r a n d i a l l y. E C A wa s i r r e g u l a r w i t h nonuniform morphology and occasionally migrated in an orad direction. ECA was occasionally uncoupled; coupling is a phenomenon in which corresponding ECAs recorded from different areas maintain a consistent time shift [6] . In spite of these functional abnormalities, the histology was minimally altered. These changes in electrical activity suggest a profound change in the physiology of the smooth muscle as well as the nerves controlling the muscle.Gastrointestinal smooth muscle contractile activity can also be influenced by extrinsic autonomic (parasympathetic and sympathetic) from the CNS and the intrinsic neurons of the enteric ner vous system. The stomach, small intestine and proximal colon derive their parasympathetic innervation through the vagus nerve which contains both afferent and efferent fibers. Relative to the intrinsic enteric neurons, the efferent potion of the vagus is really quite small; however, each vagal efferent fiber may influence about 2000 enteric neurons [7,8] . The sensory component of the vagus nerve is much greater. Sensory fibers account for 80% of all vagal fibers [9] . Vagal afferents detect both the mechanical and chemical stimulation of the small intestine and relay this information centrally for processing. Sympathetic innervation of the intestine arises from the thoracic and lumbar spinal nerves. These �� Effects of radiation upon gastrointestinal motility AbstractWhether due to therapeutic or belligerent exposure, the gastrointestinal effects of irradiation produce symptoms dreaded by a majority of the population. Nausea, vomiting, diarrhea and abdominal cramping are hallmarks of the prodromal ph...

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“…Beside the fact that toxicity-grading systems are not used uniformly by investigators [30] , they are being adjusted on a regular basis. More importantly however, clinical symptoms correlate poorly with objective parameters of gut damage such as altered morphology [28,31] , sugar permeability tests [32][33][34] or treatment related parameters [30] , illustrating the complexity of the pathophysiology of clinical symptoms related to cytotoxic treatment induced small bowel damage [35][36][37] . Because of the limitations related to the assessment of morphological endpoints in patients, investigators have used several surrogate endpoints for measuring small bowel dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…Some of these functional changes have been correlated with the epithelial cell mass available for absorption [23][24][25][26] suggesting a cellular basis in at least part of radiation induced functional disorders. of treatment, although altered intestinal motor activity is another contributing factor throughout the treatment course and following treatment [27][28][29] . Beside the fact that toxicity-grading systems are not used uniformly by investigators [30] , they are being adjusted on a regular basis.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers for radiation-induced small bowel epithelial damage: An emerging role for plasma Citrulline

Lutgens¹,

Lambin²

2007

WJG

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Reduction of cancer treatment-induced mucosal injury has been recognized as an important target for improving the therapeutic ratio as well as reducing the economic burden associated with these treatment related sequellae. Clinical studies addressing this issue are hampered by the fact that specific objective parameters, which enable monitoring of damage in routine clinical practice, are lacking. This review summarizes pros and cons of currently available endpoints for intestinal injury. The metabolic background and characteristics of plasma citrulline, a recently investigated biomarker specifically for small intestinal injury, are discussed in more detail.

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Effects of Fractionated Abdominal Irradiation on Small Intestinal MotilityStudies in a Novel In Vitro Animal Model

Cited by 12 publications

References 22 publications

Obscure gastrointestinal bleeding: a complication of radiation enteritis diagnosed by wireless capsule endoscopy

Obscure gastrointestinal bleeding: a complication of radiation enteritis diagnosed by wireless capsule endoscopy

Effects of radiation upon gastrointestinal motility

Biomarkers for radiation-induced small bowel epithelial damage: An emerging role for plasma Citrulline

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