Stereospecific Effects of Intraduodenal Tryptophan on Pyloric and Duodenal Motility in Humans

Edelbroek, M.; Sun, W. M.; Horowitz, M.; Smout, A. J. P. M.; Akkermans, L.M.A.

doi:10.3109/00365529409094893

Cited by 26 publications

(20 citation statements)

References 36 publications

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“…Reduced antral motility may explain the delay in gastric emptying seen during infusion of intravenous amino acids 14. A recent study showed that intraduodenal l -tryptophan stimulates pyloric motility and may induce premature duodenal phase III activity 20. The present study shows that not only intraluminal but also intravenous amino acids affect antroduodenal motility.…”

Section: Discussionsupporting

confidence: 53%

Effect of intravenous amino acids on interdigestive antroduodenal motility and small bowel transit time

Gielkens

Biggelaar

Vecht

et al. 1999

Gut

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Background-Patients on total parenteral nutrition have an increased risk of developing gallstones because of gall bladder hypomotility. High dose amino acids may prevent biliary stasis by stimulating gall bladder emptying. Aims-To investigate whether intravenous amino acids also influence antroduodenal motility. Methods-Eight healthy volunteers received, on three separate occasions, intravenous saline (control), low dose amino acids (LDA), or high dose amino acids (HDA). Antroduodenal motility was recorded by perfusion manometry and duodenocaecal transit time (DCTT) using the lactulose breath hydrogen test. Results-DCTT was significantly prolonged during LDA and HDA treatment compared with control. The interdigestive motor pattern was maintained and migrating motor complex (MMC) cycle length was significantly reduced during HDA compared with control and LDA due to a significant reduction in phase II duration. Significantly fewer phase IIIs originated in the gastric antrum during LDA and HDA compared with control. Duodenal phase II motility index was significantly reduced during HDA, but not during LDA, compared with control. Conclusions-Separate intravenous infusion of high doses of amino acids in healthy volunteers: (1) modulates interdigestive antroduodenal motility; (2) shortens MMC cycle length due to a reduced duration of phase II with a lower contractile incidence both in the antrum and duodenum (phase I remains unchanged whereas the eVect on phase III is diverse: in the antrum phase III is suppressed and in the duodenum the frequency is increased); and (3) prolongs interdigestive DCTT. (Gut 1999;44:240-245)

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Section: Discussionsupporting

confidence: 53%

Effect of intravenous amino acids on interdigestive antroduodenal motility and small bowel transit time

Gielkens

Biggelaar

Vecht

et al. 1999

Gut

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“…Interdigestive phases were recognized visually according to established criteria (17). The manometric recordings obtained after completion of the intraduodenal nutrient infusion were analyzed in 10-min blocks.…”

Section: Manometric Analysismentioning

confidence: 99%

Small Bowel Motility Affects Glucose Absorption in a Healthy Man

et al. 2002

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OBJECTIVE -To investigate the relationship between duodenojejunal motor activity and glucose absorption and to evaluate the effect of modification of duodenojejunal motility on glucose absorption by using the prokinetic drug cisapride.RESEARCH DESIGN AND METHODS -We examined seven healthy males, mean age 22 years, who were treated with cisapride 10 mg t.i.d. and placebo during 3 days in a randomized order, with a 2-week time interval. Duodenojejunal manometry was performed after each treatment on the morning of day 3, using an 18-lumen catheter. A liquid nutrient (3 kcal/min) was administered intraduodenally for 30 min, followed by a bolus of the glucose analog 3-Omethylglucose (3-OMG). Plasma 3-OMG concentrations were measured to assess absorption kinetics.RESULTS -The area under the 3-OMG concentration curve in the first 30 min after infusion was related to the number of antegrade propagated pressure waves (r ϭ 0.49, P Ͻ 0.05), but not to the peak concentration, time to peak, and absorption fraction. The mean amplitude of pressure waves was higher during cisapride than placebo (P Ͻ 0.05), but the reoccurrence of interdigestive motility, numbers of pressure waves, and propagated pressure waves, as well as 3-OMG absorption characteristics, were not significantly different between the two treatments. During both treatments Ͼ60% of antegrade propagated pressure waves were propagated over a very short distance (1.5 cm).CONCLUSIONS -Glucose absorption in the human small intestine is related to shorttraveling propagated intestinal contractile activity. Cisapride increases the amplitude of pressure waves, but does not affect the organization of pressure waves or the absorption of 3-OMG. Diabetes Care 25:1857-1861, 2002D igestion and absorption of nutrients are the primary functions of the small bowel. Small intestinal motor activity serves to facilitate exposure of luminal contents to the mucosal surface. Studies demonstrating the interactions between intestinal motility and nutrient absorption are few and have yielded conflicting results (1-5). This may be due to the fact that the interaction is complex and dependent on the organization of motor activity (i.e., propagated or nonpropagated) and is also affected by neuroendocrine factors.Recent studies have provided insights into the relationships between gastrointestinal motor function and glucose absorption, showing that variation in the rate of gastric emptying accounts for ϳ35% of the variance in peak blood glucose concentrations after ingestion of glucose, and that increased small intestinalpropagated activity results in the blunting of the postprandial glycemic peak (6).In the present study we used the prokinetic drug cisapride as a tool to modify small intestinal transit. Transit studies have shown the propulsive properties of cisapride in the small intestine (7,8) and its effects on fasting and postprandial gastrointestinal motility have been well established (9 -13).Several reports have shown that the spatiotemporal organization of pressure waves (i.e., propag...

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“…11 In health, nutrient delivery from the stomach to the small intestine is tightly regulated at 2-3 kcal/min 12 by small intestinal feedback. Small intestinal glucose 13 , lipid, 14 and amino acid 15 infusions stimulate pyloric and suppress antral and duodenal motility. The increase in pyloric motility is associated with slowing of gastric emptying 16 as a consequence of occlusion of transpyloric flow.…”

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confidence: 99%

Antro-pyloro-duodenal motor responses to gastric and duodenal nutrient in critically ill patients

Chapman

2005

Gut

102

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Background: Gastric emptying is frequently delayed in critical illness which compromises the success of nasogastric nutrition. The underlying motor dysfunctions are poorly defined. Aims: To characterise antro-pyloro-duodenal motility during fasting, and in response to gastric and duodenal nutrient, as well as to evaluate the relationship between gastric emptying and motility, in the critically ill. Subjects: Fifteen mechanically ventilated patients from a mixed intensive care unit; 10 healthy volunteers. Methods: Antro-pyloro-duodenal pressures were recorded during fasting, after intragastric administration (100 ml; 100 kcal), and during small intestinal infusion of liquid nutrient (6 hours; 1 kcal/min). Gastric emptying was measured using a 13 C octanoate breath test. Results: In healthy subjects, neither gastric nor small intestinal nutrient affected antro-pyloro-duodenal pressures. In patients, duodenal nutrient infusion reduced antral activity compared with both fasting and healthy subjects (0.03 (0-2.47) waves/min v 0.14 (0-2.2) fasting (p = 0.016); and v 0.33 (0-2.57)/min in healthy subjects (p = 0.005)). Basal pyloric pressure and the frequency of phasic pyloric pressure waves were increased in patients during duodenal nutrient infusion

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Stereospecific Effects of Intraduodenal Tryptophan on Pyloric and Duodenal Motility in Humans

Cited by 26 publications

References 36 publications

Effect of intravenous amino acids on interdigestive antroduodenal motility and small bowel transit time

Effect of intravenous amino acids on interdigestive antroduodenal motility and small bowel transit time

Small Bowel Motility Affects Glucose Absorption in a Healthy Man

Antro-pyloro-duodenal motor responses to gastric and duodenal nutrient in critically ill patients

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