The ileal brake--inhibition of jejunal motility after ileal fat perfusion in man.

Spiller, Robin C.; Trotman, I F; Higgins, B. E.; Ghatei, Mohammad A.; Grimble, GK; Lee, Y C; Bloom, S R; Misiewicz, J. J.; Silk, D. B. A.

doi:10.1136/gut.25.4.365

Cited by 407 publications

(196 citation statements)

References 34 publications

Supporting

Mentioning

184

Contrasting

Unclassified

Order By: Relevance

“…Nutrients administered into the ileum inhibit gastric emptying, 6 slow intestinal motility and transit, 7,21 decrease exocrine pancreatic secretion 9 and reduce food intake. 8 These effects have been attributed to the activation of the ileal brake mechanism.…”

Section: Discussionmentioning

confidence: 99%

Effect of ileal fat perfusion on satiety and hormone release in healthy volunteers

et al. 2008

View full text Add to dashboard Cite

Objective: The ileal brake is a feedback mechanism activated by nutrients, especially fat, with marked effects on satiety. The effects of low doses of ileal fat on satiety are largely unknown. We therefore studied the effect of ileal vs oral delivery of low doses of fat on satiety and gut peptide secretion. Design: Randomized, single-blind crossover design. Subjects: Sixteen healthy, normal-weight volunteers (6 male; mean age 26 years, mean body mass index 22.4). Intervention: Participants were intubated with a 290-cm-long nasoileal tube and consumed, on 3 consecutive days, either a liquid breakfast with 3 g fat followed by an ileal placebo infusion at t ¼ 105-150 min (treatment C) or a fat-free liquid breakfast followed by an ileal infusion of either an emulsion of 3 g (treatment I3g) or 9 g (treatment I9g) fat (safflower oil). Measurements: Satiety parameters by visual analog scales and plasma concentrations of CCK and PYY. Results: C significantly increased satiety and CCK secretion compared with the fat-free breakfast. Ileal fat perfusion of both 3 and 9 g (I3g and I9g) significantly increased satiety during and after fat perfusion, without differences in satiety between I3g and I9g. During ileal fat infusion, CCK increased dose dependently, whereas PYY concentrations increased significantly only after 9 g of fat. Secretion of CCK but not of PYY correlated to satiety levels. Conclusion: Postprandial satiety following a liquid breakfast can be effectively and significantly increased by small amounts (as little as 3 g) of fat perfused into the ileum. Ileal fat dose-dependently increased CCK but not PYY secretion. The satiating effect of ileal fat may be partly mediated by CCK.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of ileal fat perfusion on satiety and hormone release in healthy volunteers

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Beal infusion of triglyceride emulsions delay gastric emptying and small bowel transit in human volunteers (Spiller et al, 1984;Read et al, 1984) and stomach to caecum transit time in rats (Brown et al, 1987). The mechanism by which this effect occurs remains largely unknown.…”

Section: Introductionmentioning

confidence: 99%

“…The mechanism by which this effect occurs remains largely unknown. Spiller and colleagues showed that in normal volunteers the inhibition of small bowel motor activity induced by infusion of fatty acids into the small intestine, 170cm from the teeth was associated with elevation of the gastrointestinal peptides neurotensin and enteroglucagon (Spiller et al, 1984). However, data from our laboratory showed that the ileal infusion (205 cm) of Intralipid did not result in increased plasma levels of neurotensin and enteroglucagon, but jejunal infusion of Intralipid caused an increase in plasma levels of both hormones without delaying small bowel transit .…”

Section: Introductionmentioning

confidence: 99%

The effect of adrenoceptor antagonists on the ileal brake mechanism in the rat

Brown

Rumsey

Bogentoft

et al. 1992

British J Pharmacology

View full text Add to dashboard Cite

Studies were carried out in the rat to investigate the effect of adrenoceptor antagonists on stomach to caecum transit time under control conditions and during ileal infusion of Intralipid. Stomach to caecum transit time (SCTT) of the head of the meal was measured by use of environmental hydrogen analysis and the distribution of the meal was assessed by a scintigraphic technique. Four adrenoceptor antagonists were used in these studies, the α1 antagonist prazosin, the α2 antagonist, idazoxan, the β1 antagonist atenolol and the β2 antagonist ICI 118551. None of the antagonists affected SCTT of the head of the meal during ileal infusion of saline. However, the α1 and β1 antagonists significantly reversed (P < 0.05) the delay in SCTT induced by ileal infusion of Intralipid whereas the α2 antagonist, idazoxan, potentiated this delay (P < 0.05). Study of the distribution of the radiolabelled meal showed that the Intralipid delayed SCTT by slowing both gastric emptying (P < 0.05) and small bowel transit (P < 0.05). Prazosin delayed gastric emptying under control conditions (P < 0.001) but did not alter significantly the effect of ileal lipid on the distribution of the meal, 100 min or 200 min after gavage. Idazoxan delayed gastric emptying during ileal infusion of saline (P < 0.05) and produced a proximal shift in the geometric centre of the meal in the small intestine (P < 0.001) and despite the apparent potentiation of the ileal brake effect indicated by the hydrogen analysis, idazoxan increased the amount of radioactivity in the colon 200 min after gavage (P < 0.05). The meal distribution was more compatible with the hydrogen analysis after administration of the β‐adrenoceptor antagonists. The reversal of the lipid‐induced delay in SCTT caused by atenolol was associated with more radioactivity in the large intestine 200 min after the gavage. ICI 118551 had no significant effects on either the distribution of the meal or the SCTT of the head of the meal. In conclusion, the data confirm that the sympathetic nervous system normally modulates or mediates the mechanisms that influence gastrointestinal transit in the rat and suggest that these mechanisms may be involved in the ileal brake effect. Nevertheless the data also suggest that simple measurement of the transit of the head of the meal by use of environmental hydrogen analysis may sometimes give a misleading impression of the action of drugs on gastrointestinal transit of the bulk of a test meal.

show abstract

“…The presence of these nutrients in the ileum decreases gastrointestinal motility, gastric emptying, the speed of transit from the mouth to the cecum and consequently food intake, known as ileal brake mechanism 30 . This neural mechanism would be mediated by hormones produced in the ileum as the PYY and GLP-1 7,19,26 .…”

Section: Discussionmentioning

confidence: 99%

Gastroplastia como tratamento do diabete melito tipo 2

Branco-Filho¹,

Menacho²,

Nassif³

et al. 2011

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

-Background -Diabetes mellitus type 2 is not infrequently associated with obesity and can be prevented, improved and even reversed with the different types of bariatric operations. Aim -To compare serum glucose levels on pre and postoperative periods in patients undergoing gastroplasty with Capella and gastric sleeve techniques. Method -A descriptive and prospective analysis of serum glucose levels was done on pre and post-operative patients undergoing these operations. Results -Of the 83 patients analyzed, 76 (91.5%) were female. Ages ranged from 21 to 64 years, with average age of 44 years. Seventy-seven (92.7%) underwent gastroplasty (Capella) and six (7.3%) to gastric sleeve. The pre-operative blood glucose ranged from 125 to 500 mg / dL and dropped to 76 to 120 mg / dL in the post-operative period of three months. Of the 77 patients taking medication for diabetes, 57 had metformin 850 to 3500 mg daily, 18 glibenclamide 5 to 10 mg per day and 17 insulin. After three months of operation, 92.2% stopped using drugs for diabetes and 100% of those who remained medicated decreased from more than 65% the dose of the drug, and none remained dependent of insulin treatment. Conclusion -Bariatric surgery is effective method to improve and even reverse type 2 diabetes mellitus. ABCDDV/814RESUMO -Racional -O diabete melito tipo 2 está, com certa frequência, associado à obesidade mórbida e pode ser prevenido, melhorado e até mesmo revertido com as diversas modalidades de operações bariátricas. Objetivos -Comparar as glicemias séricas pré e pós-operatórias dos pacientes submetidos à gastroplastia com as técnicas de Capella e sleeve gástrico. Método -Estudo descritivo e prospectivo com análises das glicemias séricas pré e pós-operatórias de pacientes submetidos à gastroplastia. Resultados -Dos 83 pacientes analisados, 76 (91,5%) eram do sexo feminino. A idade variou de 21 a 64 anos, sendo 44 anos a idade média. Setenta e sete (92,7%) foram submetidos à gastroplastia (Capella) e seis (7,3%) à sleeve gástrico. A glicemia pré-operatória variou de 125 a 500 mg/dL caindo para a variação de 76 a 120 mg/dL no pós-operatório de três meses. Dos 77 pacientes que usavam tratamento medicamentoso para a diabete, 57 tomavam metformina de 850 a 3500 mg por dia, 18 glibenclamida de 5 a 10 mg por dia e 17 insulina. Após 3 meses da operação, 92,2% cessaram o uso de medicamentos para diabete e em 100% dos que permaneceram medicados houve redução de mais de 65% na dose do fármaco, sendo que nenhum permaneceu dependente de insulina no tratamento. Conclusão -A cirurgia bariátrica constitui-se em método eficaz para a melhora e até mesmo reversão do diabete melito tipo 2.

show abstract

The ileal brake--inhibition of jejunal motility after ileal fat perfusion in man.

Cited by 407 publications

References 34 publications

Effect of ileal fat perfusion on satiety and hormone release in healthy volunteers

Effect of ileal fat perfusion on satiety and hormone release in healthy volunteers

The effect of adrenoceptor antagonists on the ileal brake mechanism in the rat

Gastroplastia como tratamento do diabete melito tipo 2

Contact Info

Product

Resources

About