Gastric emptying of solids in man.

Abstract

SUMMARY The influence of the type and size of solid particles on their emptying from the stomach was studied using isotopically labelled chicken liver and inert particles in normal subjects and in patients who had undergone gastric surgery. In normal subjects, initial emptying of the liver was slower than that of inert particles both for large liver cubes (1 cm) and small cubes (0.3 cm). Liver emptying subsequently accelerated to be faster than emptying of the inert particles. Overall emptying of the liver given as small cubes was faster than large cubes; 50% emptied in 50 minutes and 70 minutes respectively. In the postoperative subjects, emptying of the liver and of the inert particles was identical. The findings are consistent with the hypothesis that solid foods such as liver are ground down and 'liquefied' by the action of gastric peristalsis before being discharged to the duodenum. Ingested particle size appears to influence the rapidity of this process, which should be distinguished from the propulsive function of the stomach where small solid particles are concerned.After the ingestion of a mixed liquid and solid meal, the liquid component empties from the stomach more rapidly than the solid. Although there is still debate about the relative importance of the proximal stomach' and of gastric peristalsis2 in controlling the emptying of liquids, it is generally agreed that the emptying of solids is controlled by the distal stomach,3 where peristaltic activity also serves to grind and mix the gastric contents before their delivery to the duodenum. Recent interest in the gastric emptying of solids has led to the development of several radioisotopically labelled solid foods suitable for study by scintigraphic methods. Liver labelled with technetium 99m has been particularly favoured46 but emptying studies using bread7 and egg white,8 cellulose fibre,9 and bran'0 have also been described.We have previously reported studies of gastric emptying in man using small inert particles labelled with technetium 99m, which are added to a normal meal.11 These particles are emptied from the stomach in an approximately linear manner with time, corresponding to the pattern observed for solids which are normal dietary constituents. How-* Present address:

Gastric Emptying of Three Different Size of Indigestible Radiopaque Markers in Healthy Subjects.

“…The present study was to clarify the affect of the diameters of indigestible solids in humans. It was reported in humans that in the fed state the pyloric sphincter is contracted and only small indigestible solids (less than 5.0 mm) are able to empty as "fortuitous emptying" with the meal, but large objects are not emptied in such a manner (Holt et al, 1982). It was also reported that the emptying of indigestible solids depends largely on the composition of the meal (Ewe et al, 1991) .…”

“…Several reports have shown that the gastric emptyings of liquids, digestible solids, and indigestible solids do not take place at the same rate (Holt et al, 1982Mojaverian et al, 1985.…”

“…, Correspondence to : Yoko Horikawa, First Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, under 2.5 mm (Holt et al, 1982). Others reported that using polyethylene tubes of 2.0 mm diameter and different lengths (2.0 mm and 10.0 mm) does not affect gastric emptying (Smith et al, 1986) and the polyethylene tube of 2.0 mm diameter and 5.0 mm length emptied simultane ously during the emptying of digestible solids (Brogna et al, 1992).…”

Scintigraphic Evaluation of a Novel Colon-Targeted Delivery System (CODES™) in Healthy Volunteers

“…The major factor influencing the gastric emptying of oral dosage forms is whether they are administered with or without food. 12 In the fasted state, drug preparations are retained in the stomach until they are removed by the phase III contractions of the migrating myoelectric complex (MMC). Phase III of the MMC is known as the ''housekeeper wave'' and acts to empty the stomach of swallowed saliva, cellular debris, and indigestible solids.…”

Déafférentation vagale totale et évacuation gastrique chez le porc

“…La fonction de l'antre est en fait d'exprimer les suspensions de fines particules susceptibles d'évacuation à l'instar des liquides (Hinder et Kelly, 1980) et de retenir et triturer les solides pour en assurer la liquéfaction (Meyer et al, 1979 ;Meyer, 1980). Ce rôle de filtre sélectif est vérifié chez le porc (Clémens et al, 1975) comme chez l'Homme (Malagelada, 1977 ;Holt et al, 1982). Mais (Laplace, 1982 (Nagaoka, 1968 ;Kelly et Code, 1969 ;Wilbur et Kelly, 1973 ;Stoddard et al, 1973 ;Bone et al, 1977a) ; défaut de coordination des activités antrales et duodénales (Stoddard et Duthie, 1976).…”