Hyperglycaemia affects proximal gastric motor and sensory function in normal subjects

Hebbard, Geoffrey; Sun, Wei; Horowitz, M.

doi:10.1097/00042737-199603000-00005

Cited by 92 publications

(81 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our data confirm that proximal gastric distension, when not accompanied by food intake, has a weaker effect on hunger than on fullness (8), thus suggesting that the former is not simply the reciprocal of the latter.…”

Section: Discussionsupporting

confidence: 78%

Effect of prolonged gastric distension on motor function of LES and of proximal stomach

Allocca

Mangano

Penagini

2002

American Journal of Physiology-Gastrointestinal and Liver Physi

View full text Add to dashboard Cite

Allocca, M., M. Mangano, and R. Penagini. Effect of prolonged gastric distension on motor function of LES and of proximal stomach. Am J Physiol Gastrointest Liver Physiol 283: G677-G680, 2002. First published April 10, 2002 10.1152/ajpgi.00526.2001.-Gastric distension is a potent stimulus of transient lower esophageal sphincter (LES) relaxation. To investigate the time effect of prolonged gastric distension on the rate of transient LES relaxations, LES pressure, and the motor and sensory functions of the proximal stomach, we performed a continuous isobaric distension of the proximal stomach at the 75% threshold pressure for discomfort for 2 h in seven healthy subjects. A multilumen assembly incorporating a sleeve and an electronic barostat was used. The rate of transient LES relaxations (n/30 min) was constant during the first hour [4.1 Ϯ 1.2 (0-30 min) and 5.4 Ϯ 1.1 (30-60 min)] but markedly decreased (P Ͻ 0.05) in the second hour [2.1 Ϯ 0.5 (60-90 min) and 2.3 Ϯ 0.9 (90-120 min)], whereas LES pressure, baseline volume and volume waves within the gastric bag, hunger, and fullness did not change throughout the experiment. It is concluded that the rate of transient LES relaxations decreases with time during prolonged gastric distension, thus suggesting that this type of stimulus should not be used in sequential experimental conditions. gastric tone; lower esophageal sphincter pressure; barostat TRANSIENT LOWER ESOPHAGEAL SPHINCTER (LES) relaxation is the mechanism that allows venting of gas during belching, and it is now established to represent an important motor event underlying gastroesophageal reflux (GER) in patients with GER disease (6, 16). There is ongoing interest in developing drugs that can decrease GER by interfering with transient LES relaxations (3,9,14,15,19). In addition to exploring possible new approaches to the treatment of GER disease, this research is valuable in gathering information concerning the neural pathways involved in the control of transient LES relaxations. To perform studies of an acceptable duration, the rate of transient LES relaxations needs to be stimulated. This has so far been done by means of various experimental models that have used proximal gastric distension as a stimulus (7, 10). The most physiological model is the ingestion of a meal, but because the rate of transient LES relaxations is not constant over the postprandial period (11, 18), presumably because of gastric emptying, it is difficult to assess more than one experimental condition per day. Furthermore, this model, as well as others using gas (24), liquid infusion in the fundus (12, 19), or balloon inflation without the use of a barostat (10), does not allow simultaneous monitoring of the effects of the study drug on the rate of transient LES relaxations and proximal gastric motor function. Understanding the relationship between these two variables is vital to increase our knowledge of the control of transient LES relaxations and for future drug development (23).Distension of the proximal stomach by means of a...

show abstract

Section: Discussionsupporting

confidence: 78%

Effect of prolonged gastric distension on motor function of LES and of proximal stomach

Allocca

Mangano

Penagini

2002

American Journal of Physiology-Gastrointestinal and Liver Physi

View full text Add to dashboard Cite

show abstract

“…Third, visceral sensitivity is influenced by actual blood glucose concentrations. Sensations may be induced by a meal during hyperglycemia that are not experienced by the subject during euglycemia (33,34).…”

Section: Gastrointestinal Sensations In Patients With Diabetesmentioning

confidence: 99%

“…The pathophysiological mechanisms that have been shown to be of importance apart from delayed gastric emptying are impaired accommodation of the stomach and increased visceral sensitivity and hyperglycemia (33)(34)(35)(36).…”

Section: Gastrointestinal Sensations In Patients With Diabetesmentioning

confidence: 99%

Prevalence of Delayed Gastric Emptying in Diabetic Patients and Relationship to Dyspeptic Symptoms

Vermeijden²,

et al. 2003

View full text Add to dashboard Cite

OBJECTIVE -Data on the prevalence of abnormal gastric emptying in diabetic patients are still lacking. The relation between gastric emptying and dyspeptic symptoms assessed during gastric emptying measurement has not yet been investigated. The aim was to investigate the prevalence of delayed gastric emptying in a large cohort of unselected diabetic patients and to investigate the relation between gastric emptying and gastrointestinal sensations experienced in the 2 weeks before and during the test meal, prospectively.RESEARCH DESIGN AND METHODS -Gastric emptying was evaluated in 186 patients (106 with type 1 diabetes, mean duration of diabetes 11.6 Ϯ 11.3 years) using 100 mg 13 C-enriched octanoic acid added to a solid meal.RESULTS -Gastric emptying was significantly slower in the diabetic subjects than in the healthy volunteers (T 50 : 99.5 Ϯ 35.4 vs. 76.8 Ϯ 21.4 min, P Ͻ 0.003; Ret 120 min : 30.6 Ϯ 17.2 vs. 20.4 Ϯ 9.7%, P Ͻ 0.006). Delayed gastric emptying was observed in 51 (28%) diabetic subjects. The sensations experienced in the 2 weeks before the test were weakly correlated with the sensation scored during the gastric emptying test. Sensations assessed during the gastric emptying test did predict gastric emptying to some extent (r ϭ 0.46, P Ͻ 0.0001), whereas sensations experienced in the previous 2 weeks did not.CONCLUSIONS -This prospective study shows that delayed gastric emptying can be observed in 28% of unselected patients with diabetes. Upper gastrointestinal sensations scored during the gastric emptying tests do predict the rate of gastric emptying to some extent and sensation experienced during daily life does not. Diabetes Care 26:3116 -3122, 2003T he prevalence of delayed gastric emptying in patients with diabetes has been subject to debate for several decades. Cross-sectional studies using scintigraphic techniques to measure gastric emptying have shown delayed gastric emptying in patients with diabetes varying from 30 to 60% (1-11). However, there are several important limitations to these studies. First, the vast majority of these studies have been performed in small numbers of patients or in selected patients, which may account for the high percentage of patients showing delayed gastric emptying in some of these studies. Second, none of these studies has been performed during relative euglycemic conditions, whereas recent studies have provided evidence that hyperglycemia has a substantial effect on the rate of gastric emptying (12,13). After taking the aforementioned into account, the prevalence of delayed gastric emptying in diabetic patients who are not selected for gastrointestinal symptoms has yet to be determined.Previous studies have reported a weak association between gastric emptying and upper gastrointestinal symptoms experienced by patients in the period preceding the gastric emptying test, with the exception of the study performed by Jones et al. (10). They studied a large cohort of diabetic subjects over a period Ͼ10 years and reported that abdominal bloating and fullness were as...

show abstract

“…10 In our study, fentanyl administration in the PACU was more frequent in the CSL/dextrose than control indicating a possible relationship between hyperglycemia and opioid tolerance. Because acute hyperglycemia is also associated with increased sensitivity to gastric distension, 5 the observed increase in fentanyl consumption in the CSL/dextrose group may indicate a hyperglycemia mediated increase in sensitivity to autonomic components of visceral nociception. This study has potential limitations.…”

mentioning

confidence: 96%

“…The immediate postoperative period was associated with hyperglycemia in our patients in the CSL/dextrose group. Hyperglycemia is known to reduce gastric emptying and increase sensation of gastric fullness 5 and is associated with adverse neurological, 6 cardiovascular, 7 gastrointestinal 5 and immunological 8 effects. The previously demonstrated small benefit in subjective postoperative recovery symptoms may be insufficient to justify administration of solutions that cause hyperglycemia.…”

mentioning

confidence: 99%

Une charge liquidienne avec ou sans dextrose supplémentaire ne prévient pas les nausées, les vomissements et la douleur après une laparoscopie

McCaul

Moran

O’Cronin

et al. 2003

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

Hyperglycaemia affects proximal gastric motor and sensory function in normal subjects

Cited by 92 publications

References 0 publications

Effect of prolonged gastric distension on motor function of LES and of proximal stomach

Effect of prolonged gastric distension on motor function of LES and of proximal stomach

Prevalence of Delayed Gastric Emptying in Diabetic Patients and Relationship to Dyspeptic Symptoms

Une charge liquidienne avec ou sans dextrose supplémentaire ne prévient pas les nausées, les vomissements et la douleur après une laparoscopie

Contact Info

Product

Resources

About