Functional association between proximal and distal gastric motility during fasting and duodenal nutrient stimulation in humans

Nguyen, Nam Q.; Fraser, Robert; Bryant, Laura; Holloway, Richard H.

doi:10.1111/j.1365-2982.2007.00919.x

Cited by 12 publications

(6 citation statements)

References 33 publications

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“…Slow fundic contractions are believed to transfer gastric contents from the fundus to the antrum for trituration and subsequent GE. These contractions might be affected by gastrostomy placement in the gastric body 21. To clarify the cause for delay in GE, motility tests such as three-dimensional ultrasonography or dynamic contrast-enhanced magnetic resonance imaging of the stomach may be useful.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Gastrostomy Placement on Gastric Function in Children: a Prospective Cohort Study

Franken

Mauritz

Stellato

et al. 2017

Journal of Gastrointestinal Surgery

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BackgroundA gastrostomy placement is frequently performed in pediatric patients who require long-term enteral tube feeding. Unfortunately, postoperative complications such as leakage, feeding intolerance, and gastroesophageal reflux frequently occur. These complications may be due to postoperative gastric dysmotility. Our aim was to evaluate the effect of gastrostomy placement on gastric emptying in children.MethodsA prospective study was performed including 50 children undergoing laparoscopic gastrostomy. Before and 3 months after gastrostomy, assessment was performed using the 13C-octanoic acid breath test, 24-h pH monitoring, and reflux symptom questionnaires.ResultsGastric half-emptying time significantly increased from the 57th to the 79th percentile (p < 0.001) after gastrostomy (p < 0.001). Fifty percent of patients with normal preoperative gastric emptying develop delayed gastric emptying (DGE, P > 95) after gastrostomy (p = 0.01). Most patients (≥75%) with leakage and/or feeding intolerance after gastrostomy had DGE after operation. A decrease in gastric emptying was associated with an increase in esophageal acid exposure time (r = 0.375, p < 0.001).ConclusionGastrostomy placement in children causes a significant delay in gastric emptying. Postoperative DGE was associated with gastroesophageal reflux and was found in most patients with postoperative leakage and feeding intolerance. These negative physiologic effects should be taken into account when considering gastrostomy placement in children.

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Section: Discussionmentioning

confidence: 99%

The Effect of Gastrostomy Placement on Gastric Function in Children: a Prospective Cohort Study

Franken

Mauritz

Stellato

et al. 2017

Journal of Gastrointestinal Surgery

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“…Nguyen and co-workers observed a functional association between the fundic squeeze and the antral contraction waves for both the fasting and the fed stomach. 120 The antral contraction waves originate from pacesetter cells (so-called interstitial cells of Cajal) at the greater curvature of the middle corpus. Within 60 s, peristaltic waves progress along the gastric wall toward the pylorus with velocities of around 2 to 3 mm/s and mean occlusion rates of 40% to 60%.…”

Section: ■ Processing Of Food In the Oral Cavitymentioning

confidence: 99%

Simulating the Postprandial Stomach: Physiological Considerations for Dissolution and Release Testing

Koziolek

Garbacz²,

Neumann

et al. 2013

Mol. Pharmaceutics

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Food effects on drug release and absorption from solid oral dosage forms are a common biopharmaceutical problem. The fed state is characterized by different motility and secretory activity of the complete gastrointestinal (GI) tract compared to fasting conditions. Due to long gastric transit times, the postprandial stomach plays an essential role for drug release and the appearance of food effects. Therefore, a concise comprehension of the relationship between food intake and its effect on drug release from solid oral dosage forms is essential to understand their dissolution behavior under fed conditions. This review describes important aspects of stomach physiology occurring after meal ingestion with particular reference to the FDA standard breakfast. A brief overview of oral and gastric food processing and their potential influence on drug release is given. The key factors affecting the intragastric dissolution of solid oral dosage forms and their regional distribution in the stomach are discussed. Additionally, the effects of food properties on gastric emptying kinetics are presented. Mechanical aspects such as intragastric pressures and hydrodynamics caused by gastric peristalsis are defined. The initial state and the dynamic changes of the gastric content during digestion are characterized since the different physicochemical aspects such as pH value, buffer capacity, rheological properties or surface tension may be essential for the in vivo dissolution profiles of oral dosage forms. Possible effects of the discrete interplay of the physiological factors on the in vivo drug delivery behavior of solid oral dosage forms are discussed.

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“…A number of previous studies reported that duodenal nutrients or distension reduced proximal gastric tone, delayed gastric emptying, and increased pyloric contractions (17,32). Colon-rectal distension has been reported to induce delayed gastric emptying (20,31), abnormalities of gastric slow waves (1,21), and inhibition of proximal gastric tone (12).…”

Section: Effects Of Electrical Stimulation On Slow Waves and Optimal mentioning

confidence: 99%

Effects and mechanisms of gastrointestinal electrical stimulation on slow waves: a systematic canine study

Sun¹,

Guan²,

Yin

et al. 2009

American Journal of Physiology-Regulatory, Integrative and Comp

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Sun Y, Song GQ, Yin J, Lei Y, Chen JDZ. Effects and mechanisms of gastrointestinal electrical stimulation on slow waves: a systematic canine study. Am J Physiol Regul Integr Comp Physiol 297: R1392-R1399, 2009. First published August 26, 2009 doi:10.1152/ajpregu.00006.2009.-The aims of this study were to determine optimal pacing parameters of electrical stimulation on different gut segments and to investigate effects and possible mechanisms of gastrointestinal electrical stimulation on gut slow waves. Twelve female hound-mix dogs were used in this study. A total of six pairs of electrodes were implanted on the stomach, duodenum, and ascending colon. Bilateral truncal vagotomy was performed in six of the dogs. One experiment was designed to study the effects of the pacing frequency on the entrainment of gut slow waves. Another experiment was designed to study the modulatory effects of the vagal and sympathetic pathways on gastrointestinal pacing. The frequency of slow waves was 4.88 Ϯ 0.23 cpm (range, 4 -6 cpm) in the stomach and 19.68 Ϯ 0.31 cpm (range, 18 -22 cpm) in the duodenum. There were no consistent or dominant frequencies of the slow waves in the colon. The optimal parameters to entrain slow waves were: frequency of 1.1 intrinsic frequency (IF; 10% higher than IF) and pulse width of 150 -450 ms (mean, 320.0 Ϯ 85.4 ms) for the stomach, and 1.1 IF and 10 -20 ms for the small intestine. Electrical stimulation was not able to alter colon slow waves. The maximum entrainable frequency was 1.27 IF in the stomach and 1.21 IF in the duodenum. Gastrointestinal pacing was not blocked by vagotomy nor the application of an ␣-or ␤-adrenergic receptor antagonist; whereas the induction of gastric dysrhythmia with electrical stimulation was completely blocked by the application of the ␣-or ␤-adrenergic receptor antagonist. Gastrointestinal pacing is achievable in the stomach and small intestine but not the colon, and the maximal entrainable frequency of the gastric and small intestinal slow waves is about 20% higher than the IF. The entrainment of slow waves with gastrointestinal pacing is not modulated by the vagal or sympathetic pathways, suggesting a purely peripheral or muscle effect.

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Functional association between proximal and distal gastric motility during fasting and duodenal nutrient stimulation in humans

Cited by 12 publications

References 33 publications

The Effect of Gastrostomy Placement on Gastric Function in Children: a Prospective Cohort Study

The Effect of Gastrostomy Placement on Gastric Function in Children: a Prospective Cohort Study

Simulating the Postprandial Stomach: Physiological Considerations for Dissolution and Release Testing

Effects and mechanisms of gastrointestinal electrical stimulation on slow waves: a systematic canine study

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