Postoperative ileus is maintained by intestinal immune infiltrates that activate inhibitory neural pathways in mice1 1The authors thank Prof. Yvette van Kooyk, Department of Molecular Cell Biology, Free University, Amsterdam, for her gift of blocking antibodies; Drs. Formijn van Hemert and Cynara Veeris, Department of Nuclear Medicine, Academic Medical Center, Amsterdam, for their assistance in the gastric emptying studies; and Dr. Jan M. Ruijter, Department of Anatomy and Embryology, Academic Medical Cent

Jonge, Wouter J. de; Wijngaard, René M. van den; The, Frans O.; Beek, Merel-Linde Ter; Bennink, Roel J.; Tytgat, G. N. J.; Buijs, Ruud M.; Reitsma, Pieter H.; Deventer, Sander J. van; Boeckxstaens, Guy E.

doi:10.1016/s0016-5085(03)01197-1

Cited by 178 publications

(46 citation statements)

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“…This observation is consistent with previously published reports of gastrointestinal transit's being delayed after abdominal surgery [6,7,11]. However, evaluation of the delayed gastrointestinal transit in postoperative patients is of major clinical interest, because of the higher likelihood of incomplete examination of the small bowel and the potential missing of distal small bowel abnormalities in these patients.…”

Section: Discussionsupporting

confidence: 92%

“…The pathogenesis of postoperative intestinal dysmotility is multifactorial and includes the formation of peritoneal adhesions [21], but the precise mechanism is unclear. It is mainly thought to be mediated by an inhibitory enterogastric neural pathway that is triggered by inflammatory infiltrates recruited to the intestinal muscle [6,22].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies, including animal experiments, have demonstrated prolongation of the gastrointestinal transit time after abdominal surgery [6,7]; however, data on the transit time using CE in postoperative patients are lacking. Although some previous studies on CE have evaluated the gastrointestinal transit time [8][9][10], almost all studies have defined a history of gastrointestinal or abdominal surgery as an exclusion criterion for this imaging modality.…”

Section: Introductionmentioning

confidence: 99%

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Abdominal Surgery Affects Small Bowel Transit Time and Completeness of Capsule Endoscopy

et al. 2008

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The aim of the study was to evaluate bowel dysmotility in patients with a history of abdominal surgery by measuring both gastric transit time and small bowel transit time during capsule endoscopy and assessing the completeness of the examination. The study included 26 patients who had undergone abdominal surgery (postoperative group) and 52 patients who had not (control group). The capsule reached the cecum in 50.0% of the postoperative group and 80.8% of the control group (P=0.005). While there was no significant difference in gastric transit time between the two groups (P=0.882), small bowel transit time was significantly longer in the postoperative group (338.3+/-119.2 min) than in the control group (266.4+/-110.8 min, P=0.010). This is the first study to report that the small bowel transit time during capsule endoscopy is prolonged in patients who had a history of abdominal surgery, resulting in a lower frequency of complete examination.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Abdominal Surgery Affects Small Bowel Transit Time and Completeness of Capsule Endoscopy

et al. 2008

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“…It has been suggested that afferent nerve fiber stimulation triggers neural reflexes, which inhibit gastrointestinal motility and result in POI. Delayed gastric emptying 6 h after intestinal manipulation was shown to be normalized by guanethidine [5]. This finding indicates that the adrenergic pathway is involved in mediating the early phase of POI.…”

Section: Introductionmentioning

confidence: 72%

“…Several mechanisms for the development of POI have been proposed, such as neural reflex [1][2][3] and inflammatory changes [4,5]. It has been suggested that afferent nerve fiber stimulation triggers neural reflexes, which inhibit gastrointestinal motility and result in POI.…”

Section: Introductionmentioning

confidence: 99%

Glutamine Decreases the Duration of Postoperative Ileus After Abdominal Surgery: An Experimental Study of Conscious Dogs

et al. 2008

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Postoperative ileus (POI) is a transient bowel dysmotility that occurs following many types of operations and is one of the most common complications of gastrointestinal surgery. We hypothesized that enteral supplementation of glutamine after abdominal surgery would restore fuel to the small intestine, suppress oxidative stress, and lead to improvement in POI. Twelve dogs underwent distal gastrectomy and were each randomly assigned to one of two groups based on postoperative treatment: the water injection (control) group and the glutamine injection group. Water (40 ml) or L(+)-glutamine (1 g/40 ml water) was injected into the residual stomach through the gastric tube every 12 h after surgery for 7 days. Changes in the plasma and intestinal intracellular concentration of glutamine and in gastrointestinal motility were measured. The plasma and intracellular glutamine levels decreased after the operation in both groups, although the decreased intracellular glutamine levels were not significantly different than preoperative levels. The glutamine group showed a significantly smaller decrease of the plasma glutamine level compared with the control group (P < 0.05). All the dogs showed gastrointestinal dysmotility after the operation. The mean length of time between the operation and the appearance of interdigestive migrating contractions in the glutamine group was significantly shorter than in the control group (22.4 +/- 3.1 h versus 37.8 +/- 4.0 h, respectively; P < 0.05). In conclusion, glutamine could act as a motility-recovery agent after abdominal surgery and thereby decrease the duration of POI.

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Colonic Disorders

Murray¹,

Emmanuel²

2004

Pathophysiology of the Enteric Nervous System

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Cited by 178 publications

References 29 publications

Abdominal Surgery Affects Small Bowel Transit Time and Completeness of Capsule Endoscopy

Abdominal Surgery Affects Small Bowel Transit Time and Completeness of Capsule Endoscopy

Glutamine Decreases the Duration of Postoperative Ileus After Abdominal Surgery: An Experimental Study of Conscious Dogs

Colonic Disorders

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