Small Bowel Motor Activity in Response to Physiological Meals of Different Chemical Composition in Man

Abstract

Meals disrupt the interdigestive pattern of small bowel motor activity and convert it into the more irregular postprandial pattern. Previous animal studies suggest that the duration of and contractile activity within the postprandial period depend on the chemical composition of a meal. It is not clear whether this is also true for man. In 8 healthy volunteers I investigated how physiological and isocaloric meals of different chemical composition affect small bowel motor activity. Volunteers underwent two separate, ambulatory 24-hour small bowel manometry studies. Volunteers had a total of four meals on the two study days. They ingested two identical fish meals rich in protein, a pasta meal rich in carbohydrates, and a meat meal rich in fat. Records were analyzed visually for the reappearance of phase III of the migrating motor complex, and a validated computer program calculated the incidence of contractions during the postprandial period, as well as the amplitude and propagation of contractions. The durations of the postprandial periods were similar after the two protein meals (238 +/- 35 and 227 +/- 25 min), the carbohydrate (220 +/- 23 min) and the fat meal (242 +/- 43 min). The incidence of contractions was not significantly different after the protein meals (1.6 +/- 0.3 and 1.0 +/- 0.2 contractions per min), the carbohydrate meal (1.0 +/- 0.2 contractions per min) and the fat meal (1.5 +/- 0.2 contractions per min). The amplitude of contractions was similar after the protein meals (14 +/- 0.1 and 13 +/- 0.1 mmHg), the carbohydrate meal (14 +/- 0.1 mmHg) and the fat meal (14 +/- 0.1 mmHg). Propagation of contractions was similar after the protein meals (13 +/- 3 and 18 +/- 3 %), after the carbohydrate meal (15 +/- 2 %) and after the fat meal (13 +/- 2 %). Contractile activity within consecutive 30-min periods of the postprandial period was also not different between the meals. I conclude that physiological, isocaloric meals of different chemical composition elicit a similar postprandial motor response in the human small bowel.

Patterns of Small Intestinal Motor Activity During Intraluminal Infusion of Elementary Diets in Dogs

“…Attempts to characterize this motor activity during the fed period have yielded contradictory results [3][4][5][6][7] that may be related to the species studied, composition of test meals, route of administration, and caloric load.…”

Guiding Manometry Probes into the Human Small Bowel without X-Ray: Validation of a New Technique

“…Duration of X-ray exposure was also documented. In England, tubes were placed under fluoroscopic control [6, 7], whereas in Germany the position of the catheter was controlled using a combination of sonography and pH-metry [8]. …”

“…In the sonography/pH-metry group 18 tubes were placed in 10 volunteers. Most volunteers underwent repeat investigations, due to the comparative nature of the study protocols [6,7,8]. None of the volunteers participated in both study groups, and the two volunteer groups were not significantly different.…”

“…Data from motility studies that have been published elsewhere were analyzed [8]. Data on successive tube placements are reported, as placing the tube was successful in all volunteers, although some of them failed to complete the planned 24-hour study.…”

Characteristic of duodenal myoelectric activity in relation to food in piglets during the 3rd and 4th week of life

“…In adult pigs, however, the MMC is interrupted when the animal is fed discrete, large meals, but not by ad libitum feeding with the same diet (Bueno and Ruckebusch, 1976). Other research has shown that the caloric load regulates the characteristics of the amplitude of contraction and the duration of the intestinal postprandial pattern in adult pigs (Gregory et al, 1986), dogs (Schang et al, 1978;Schmid et al, 1992) as well as in adult humans (Schönfeld et al, 1998). Furthermore, it was demonstrated in adult dogs that during enteral infusion of low caloric load, MMC persisted, apart from a lengthening of phase II and resulting increase in duration of the MMC cycles; only higher caloric load caused complete disruption of the MMC and appearance of postprandial pattern (Defilippi, 2003).…”