Effects of nitroglycerin on liquid gastric emptying and antropyloroduodenal motility

Abstract

The effects of the nitric oxide donor nitroglycerin on gastric emptying and antropyloroduodenal motility were evaluated in nine healthy male subjects (ages 19–36 yr). Antropyloroduodenal pressures were recorded with a manometric assembly that had nine side holes spanning the antrum and proximal duodenum and a pyloric sleeve sensor; gastric emptying was quantified scintigraphically. In each subject, the emptying of 300 ml of 25% glucose labeled with99mTc was assessed on two separate days during intravenous infusion of either nitroglycerin (5 μg/min in 5% dextrose) or 5% dextrose (control). Studies were performed with the subject in the supine position; blood pressure and heart rate were monitored. Nitroglycerin had no significant effect on blood pressure or heart rate. Nitroglycerin slowed gastric emptying ( P < 0.02), and this was associated with greater retention of the drink in the proximal stomach ( P < 0.05). In both nitroglycerin and control studies, ingestion of the drink was associated with an increase in the number of isolated pyloric pressure waves ( P < 0.05) and antral pressure wave sequences ( P < 0.05). Nitroglycerin reduced the number of isolated pyloric pressure waves ( P < 0.05), basal pyloric pressure ( P < 0.05), and the number of antral pressure wave sequences ( P < 0.05), but not the total number of antral pressure waves. The rate of gastric emptying and the number of isolated pyloric pressure waves were inversely related during control ( P = 0.03) and nitroglycerin ( P < 0.05) infusions. We conclude that in normal subjects, 1) gastric emptying of 300 ml of 25% glucose is inversely related to the frequency of phasic pyloric pressure waves, and 2) nitroglycerin in a dose of 5 μg/min inhibits pyloric motility, alters the organization but not the number of antral pressure waves, and slows gastric emptying and intragastric distribution of 25% glucose.

Insulin restores neuronal nitric oxide synthase expression and function that is lost in diabetic gastropathy

“…Exogenous NO reduces both the number and amplitude of isolated pyloric pressure waves in normal humans (18). NO donors also alter the distribution of liquid glucose within the stomach and may slow gastric emptying, perhaps by reducing tone in the proximal stomach (19). Endogenous NO may inhibit gastric emptying in humans (20,21), although in animal models, nNOS inhibition delays gastric emptying (22)(23)(24).…”

Relation between food intake and visual analogue scale ratings of appetite and other sensations in healthy older and young subjects

“…We have also identified ageing-associated changes in gastric function, which tend to suppress appetite and food intake. These include slower gastric emptying (Horowitz et al, 1984;Clarkston et al, 1997), delayed postprandial gastric relaxation (Rayner et al, 2000) and more distal distribution of food within the stomach associated with suppression of hunger (Clarkston et al, 1997;Sun et al, 1998).…”

Lack of Modulation of Gastric Emptying by Dietary Nitrate in Healthy Volunteers

“…The importance of NO in the gastric motor function is supported by the fact that pharmacological inhibition of the endogenous NO synthesis by L-NMMA was found to alter the gastric motor function in human by leading to accelerated gastric emptying (Konturek et al 1999). Exogenous NO originating from NO donors such as glyceryl trinitrate or isosorbide dinitrate could also affect gastric emptying, and some previous studies have demonstrated that systemic administration of these organic nitrate agents induced an inhibitory effect on gastric emptying in human (Konturek et al 1995;Sun et al 1998) although other studies failed to show a change in gastric emptying by the treatment (Stacher et al 1997;Madsen et al 2006).…”