Interdigestive antroduodenal motility and gastric acid secretion

Gielkens,; Nieuwenhuizen,; Biemond,; Lamers, None; Masclee,

doi:10.1046/j.1365-2036.1998.00267.x

Cited by 26 publications

(23 citation statements)

References 25 publications

(61 reference statements)

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“…The pH variations in relation to MMC phases observed in the present study are in accordance with previous reports (3,52,53). We also observed the typical proximal duodenal acid exposure profile during phase II, with intensive acid exposure occurring in the duodenal bulb (14,52). Studies on proximal duodenal acid exposure are technically demanding, requiring either monitoring of the transmucosal potential difference (52) or endoscopical fixation of the probe to a mucosal fold using a hemostatic clip (7) or using Bravo telemetry pH capsules (25).…”

Section: Discussionsupporting

confidence: 95%

Duodenal Acid Clearance in Humans: Observations Made with Intraluminal Impedance Recording

2005

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Duodenal acid clearance appears to be involved not only in the pathogenesis of duodenal ulcer disease but also in functional dyspepsia. Duodenal contractile activity can help to maintain neutral pH in the duodenum by mixing acid with bicarbonate or by aborally transporting the acid load. Intraluminal impedance recording, allowing the detection of nonacid liquid boluses, can be carried out concomitantly with antroduodenal manometry and pH recording and may thus provide useful information about the mechanisms involved in duodenal clearance of endogenous acid and volume boluses. Eight H. pylori-negative healthy volunteers were studied with two catheters positioned across the pylorus, allowing the recording of five impedance signals (one antral, one pyloric, and three duodenal) simultaneously with six pressure signals (two antral, one pyloric, and three duodenal) as well as distal antral and proximal duodenal pH. During phase II of the migrating motor complex, which is known to be associated with the highest duodenal acid exposure, each duodenal acidification event (defined as a pH drop >2 pH units) was characterized by its maximal amplitude, duration, temporal relationship with antroduodenal manometric events, and relation to impedance variations. Acid was considered to have been cleared from the duodenum when the preacidification pH was restored (+/-0.2 unit). A total of 164 duodenal pH drops were recorded during the 323 min of phase II recordings. Eleven percent of the duodenal acidification events were short-lived (<10 sec). All of these events were temporally associated with a propagated antroduodenal contraction and a short-lived drop in impedance, suggesting rapid aboral passage of the acid bolus. The long-lived duodenal acidification events lasted a mean of 32 sec (range, 25-66 sec). In 90% of these events an antroduodenal propagated contraction was recorded at the time of onset. Repetitive duodenal contractions followed the onset of the long-lived acidification events in 34% of the cases. These remained present until complete clearance of the acid. In 81% of the long-lived acidification events, recovery of the associated impedance drop occurred simultaneously with the pH recovery, suggesting a complete clearance of the bolus. Less frequently (19%), the duodenal pH recovered while the impedance remained low, suggesting that the bolus was not cleared but neutralized. Interdigestive duodenal acidification events usually last about 30 sec. They evoke duodenal contractions in only one-third of cases. Combined pH and impedance recording makes it possible to distinguish between neutralization of acid boluses and their complete total clearance.

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Section: Discussionsupporting

confidence: 95%

Duodenal Acid Clearance in Humans: Observations Made with Intraluminal Impedance Recording

2005

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“…Moreover, some reported that interdigestive antroduodenal motility in achlorhydria was not different from that in normal acid-secreting control subjects [11,136]. Thus, gastric acid secretion may not be essential in the regulation of interdigestive MMC, although it is known that excessive gastric acid may modulate antroduodenal motility [141].…”

Section: E) Gastric Acid Secretionmentioning

confidence: 98%

Current Concepts in Gastric Motility in Diabetes Mellitus

Block¹,

Leeuw²,

Pelckmans³

et al. 2006

CDR

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This review addresses the current concepts in our understanding of the epidemiology, mechanisms, symptoms, clinical consequences, diagnosis and treatment of delayed gastric emptying in patients with diabetes. Upper gastrointestinal symptoms, particularly postprandial fullness, nausea, vomiting and abdominal bloating, occur in 30-50% of patients with diabetes. The use of scintigraphic techniques, and more recently breath test, has shown that as many as 50% of diabetic patients have gastroparesis. Diabetic gastroparesis comprises a decrease in fundic and antral motor activity, a reduction or a lack of the interdigestive migrating motor complex, gastric dysrhythmias, and pylorospasms. The mechanisms involved include: autonomic neuropathy, acute hyperglycaemia, and abnormalities in gastrointestinal hormones and neuropeptides. Other possible contributing factors such as hypothyroidism and H. pylori infection are discussed as well. Because treatment is possible by means of dietary advise, prokinetics or surgical procedures, it is important to identify risk factors for and to diagnose gastroparesis to prevent morbidity by controlling gastrointestinal symptoms, and to enhance glucoregulation. Understanding the current advances is key to the development of novel therapeutic strategies and for making rational choices in the management of diabetic gastroparesis.

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“…ERA always appears on the ECA when depolarization overcomes a determined mechanical threshold potential (approximately À45 mV) [Lee et al, 1999], and it appears usually 1-2 s after this [Lammers, 2000]. The temporal changes in the smooth muscle spike activity (ERA) form the migrating motor complex (MMC), which appears in the postprandial state, and consists of three phases: NSA, non-spike activity phase; ISA, irregular spike activity phase; and RSA, regular spike activity phase [Code and Marlett, 1975;Gielkens et al, 1998;Kajiyama et al, 1998;Russo et al, 1999]. RSA phase of the MMC is the most easily recognized part of the MMC and it is a short burst of phasic contractions with the frequency: 3/min in the gastric antrum, 11-12/min in the proximal small bowel and 8-9/min in the ileum.…”

Section: Introductionmentioning

confidence: 99%

“…The MMC has an important role as an intestinal housekeeper [Gielkens et al, 1998;Husebye et al, 2001] because the contractions propel cellular debris, secretions, undigested food, and bacteria distally along the small intestine [Olsson and Halmgren, 2001].…”

Section: Introductionmentioning

confidence: 99%

Effect of the electrical currents generated by the intestinal smooth muscle layers on pancreatic enzyme activity: An in vitro study

Dabek

Podgurniak

Piedra

et al. 2007

Bioelectromagnetics

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Gut enzymes in the small intestine are exposed to extremely low electrical currents (ELEC) generated by the smooth muscle. In the present study, the in vitro tests were undertaken to evaluate the effect of these electric currents on the activity of the proteolytic pancreatic digestive enzymes. A simulator generating the typical electrical activity of pig gut was used for these studies. The electric current emitted by the simulator was transmitted to the samples, containing enzyme and its substrate, using platinum plate electrodes. All samples were incubated at 37 degrees C for 1 h. The changes in optical density, corresponding to enzyme activity, in samples stimulated for 1 h with ELEC was compared with that not exposed to ELEC. The obtained results show that the electrical current with the characteristics of the myoelectrical migrating complex (MMC) has an influence on pancreatic enzyme activity. Increased endopeptidase and reduced exopeptidase activity was noticed in samples treated with ELEC. This observation can be of important as analyzed factors which can alter enzymatic activity of the gut, can thus also affect feed/food digestibility.

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Interdigestive antroduodenal motility and gastric acid secretion

Abstract: Gastric acid secretion varies cyclically with interdigestive antroduodenal motility. Acute acid inhibition with intravenous famotidine does not significantly affect interdigestive antroduodenal motility.

Cited by 26 publications

References 25 publications

Duodenal Acid Clearance in Humans: Observations Made with Intraluminal Impedance Recording

Duodenal Acid Clearance in Humans: Observations Made with Intraluminal Impedance Recording

Current Concepts in Gastric Motility in Diabetes Mellitus

Effect of the electrical currents generated by the intestinal smooth muscle layers on pancreatic enzyme activity: An in vitro study

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