The Interdigestive Motor Complex of Normal Subjects and Patients with Bacterial Overgrowth of the Small Intestine

Vantrappen, Gaston; Janssens, Jozef; Hellemans, J.; Ghoos, Yvo

doi:10.1172/jci108740

Cited by 778 publications

(410 citation statements)

References 13 publications

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“…15,16 Among these mechanisms, prolonged intestinal transit, as a consequence of altered intestinal motility, seems to play a major role in the development of IBO. Delayed intestinal transit has been shown in rats with portal hypertension.…”

Section: Discussionmentioning

confidence: 99%

Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation in cirrhosis

et al. 2000

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Deranged intestinal motility, which occurs in cirrhosis, may facilitate the development of intestinal bacterial overgrowth (IBO), which can lead to bacterial translocation (BT). To assess the effect of cisapride on IBO and BT in cirrhosis, cirrhotic rats received cisapride or a placebo for 7 days, and measurements of jejunal bacterial content and BT studies were performed. In addition, jejunal fluid from 46 cirrhotic patients was obtained for quantitative bacterial culture. Those patients in whom gram-negative IBO was detected were randomized to receive or not to receive cisapride (20 mg twice per day) for 1 week. Cisapride significantly reduced IBO in cirrhotic rats. In addition, no BT was documented in treated animals, whereas it occurred in 40% in nontreated cirrhotic rats. Total IBO was documented in 23 of 46 cirrhotic patients, which was caused by gram-negative organisms in 10 cases. Orocecal transit time (OCT) significantly decreased after cisapride therapy, and was associated with the abolishment of bacterial overgrowth caused by gram-negative organisms in 4 out of 5 treated patients, whereas it persisted in nontreated cases. Cisapride administration to cirrhotic rats resulted in a reduction of the IBO, which is associated with a marked decrease in BT. On the other hand, cisapride facilitates the abolition of IBO caused by gram-negative organisms in cirrhotic patients. (HEPATOLOGY 2000;31:858-863.)

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Section: Discussionmentioning

confidence: 99%

Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation in cirrhosis

et al. 2000

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“…DURING A FASTED STATE, THE stomach and small intestine undergo a temporally coordinated cyclic motor pattern known as migrating motor complex (MMC) in dogs (38) and humans (44). It has been established that these coordinated contractions consist of three phases, phase I (period of motor quiescence), phase II (period of preceding irregular contractions), and phase III (period of clustered potent contractions), and the MMC is stimulated by endogenous motilin that is released in the fasted state.…”

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confidence: 99%

Physiological characteristics of gastric contractions and circadian gastric motility in the free-moving conscious house musk shrew (Suncus murinus)

Sakahara

Xie

Koike

et al. 2010

American Journal of Physiology-Regulatory, Integrative and Comp

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Physiological characteristics of gastric contractions and circadian gastric motility in the free-moving conscious house musk shrew (Suncus murinus). Am J Physiol Regul Integr Comp Physiol 299: R1106 -R1113, 2010. First published August 4, 2010 doi:10.1152/ajpregu.00278.2010.-Although many studies have demonstrated the physiological action of motilin on the migrating motor complex, the precise mechanisms remain obscure. To obtain new insights into the mechanisms, we focused on the house musk shrew (Suncus murinus, suncus used as a laboratory name) as a small model animal for in vivo motilin study, and we studied the physiological characteristics of suncus gastrointestinal motility. Strain gauge transducers were implanted on the serosa of the gastric body and duodenum, and we recorded gastrointestinal contractions in the free-moving conscious suncus and also examined the effects of intravenous infusion of various agents on gastrointestinal motility. During the fasted state, the suncus stomach and duodenum showed clear migrating phase III contractions (intervals of 80 -150 min) as found in humans and dogs. Motilin (bolus injection, 100-300 ng/kg; continuous infusion, 10-100 ng · kg Ϫ1 · min Ϫ1 ) and erythromycin (80 g·kg Ϫ1 · min Ϫ1 ) induced gastric phase III contractions, and motilin injection also increased the gastric motility index in a dose-dependent manner (P Ͻ 0.05, vs. saline). Pretreatment with atropine completely abolished the motilin-induced gastric phase III contractions. On the other hand, in the free-feeding condition, the suncus showed a relatively long fasting period in the light phase followed by spontaneous gastric phase III contractions. The results suggest that the suncus has almost the same gastrointestinal motility and motilin response as those found in humans and dogs, and we propose the suncus as a new small model animal for studying gastrointestinal motility and motilin in vivo.suncus; migrating motor complex; motilin; ghrelin; gastric motility DURING A FASTED STATE, THE stomach and small intestine undergo a temporally coordinated cyclic motor pattern known as migrating motor complex (MMC) in dogs (38) and humans (44). It has been established that these coordinated contractions consist of three phases, phase I (period of motor quiescence), phase II (period of preceding irregular contractions), and phase III (period of clustered potent contractions), and the MMC is stimulated by endogenous motilin that is released in the fasted state.Motilin was originally purified from porcine intestinal mucosa in the 1970s, and its molecular structure was determined to be a 22-amino-acid polypeptide. It has been demonstrated that plasma motilin is released at ϳ100-min intervals at the interdigestive state (20,21). Physiological study of motilin in vivo has been mainly performed by using dogs and humans, and endogenous motilin and exogenous motilin have been shown to induce phase III contractions through the cholinergic pathway because atropine pretreatment completely abolished the motilin-induced contra...

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“…DURING THE INTERDIGESTIVE state, the stomach and small intestine show a remarkable motor pattern, known as the migrating motor complex (MMC) in dogs (20) and humans (22). MMC consists of three phases: phase I (period of motor quiescence), phase II (period of irregular low-amplitude contractions), and phase III (period of regular high-amplitude contractions).…”

mentioning

confidence: 99%

“…MMC consists of three phases: phase I (period of motor quiescence), phase II (period of irregular low-amplitude contractions), and phase III (period of regular high-amplitude contractions). The pulsatile flow immediately ahead of phase III of the MMC implied physiological importance for clearance of secretions, debris, and microbes during fasting and let the stomach be ready to receive a next meal (22).…”

mentioning

confidence: 99%

Fixed feeding potentiates interdigestive gastric motor activity in rats: importance of eating habits for maintaining interdigestive MMC

Ariga

Imai²,

Chen³

et al. 2008

American Journal of Physiology-Gastrointestinal and Liver Physi

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Ariga H, Imai K, Chen C, Mantyh C, Pappas TN, Takahashi T. Fixed feeding potentiates interdigestive gastric motor activity in rats: importance of eating habits for maintaining interdigestive MMC. Am J Physiol Gastrointest Liver Physiol 294: G655-G659, 2008. First published January 3, 2007 doi:10.1152/ajpgi.00484.2007.-Endogenous ghrelin regulates the occurrence of interdigestive gastric phase III-like contractions in rats. However, the fasted motor pattern is not as regular and potent in humans and dogs. We hypothesize that eating habits play an important role in maintaining a regular interdigestive gastric contractions. We studied the effect of fixed-feeding regimen on interdigestive gastric contractions and plasma acyl ghrelin levels. The fixed-fed rats were trained to the assigned meal feeding regimen, once daily at 12:00 PM to 4:00 PM for 14 days. Free-fed rats were maintained with free access to food. As ghrelin regulates gastric emptying as well, solid gastric emptying was also studied in fixed-fed rats and free-fed rats. In free-fed rats, two of six rats did not show interdigestive gastric phase III-like contractions. In contrast, phase III-like contractions were observed in all rats 14 days after starting the fixed-feeding regimen. The maximal amplitude of phase III-like contractions significantly increased from 8.4 Ϯ 0.6 to 16.3 Ϯ 1.8 g (n ϭ 6, P Ͻ 0.05) 14 days after the start of the fixed feeding. Fasted and postprandial plasma ghrelin levels were significantly increased after 14 days of fixed feeding. Solid gastric emptying was significantly accelerated in fixed-fed rats (72.1 Ϯ 4.2%) compared with that of free-fed rats (58.7 Ϯ 2.7%, n ϭ 6, P Ͻ 0.05). Our present findings suggest that fixed feeding increases plasma ghrelin levels, potent interdigestive contractions, and acceleration of gastric emptying. migrating motor complex; ghrelin; scheduled feeding DURING THE INTERDIGESTIVE state, the stomach and small intestine show a remarkable motor pattern, known as the migrating motor complex (MMC) in dogs (20) and humans (22). MMC consists of three phases: phase I (period of motor quiescence), phase II (period of irregular low-amplitude contractions), and phase III (period of regular high-amplitude contractions). The pulsatile flow immediately ahead of phase III of the MMC implied physiological importance for clearance of secretions, debris, and microbes during fasting and let the stomach be ready to receive a next meal (22).The characteristic feature of gastric MMC is different among species. In humans and dogs, MMC is usually observed every 90 -120 min in the interdigestive state. In contrast, in rats, the MMC cycle is short (less than 20 min) and not as regular as that of humans and dogs (2,7,21). It is rather difficult to distinguish three phases, especially phase III(-like) contractions. Furthermore, sometimes phase III-like contractions are not clearly observed even after a 24-h fasting in rats. These may be explained by the difference of the peptides that regulate MMC. In dogs and humans, gastric ...

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The Interdigestive Motor Complex of Normal Subjects and Patients with Bacterial Overgrowth of the Small Intestine

Cited by 778 publications

References 13 publications

Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation in cirrhosis

Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation in cirrhosis

Physiological characteristics of gastric contractions and circadian gastric motility in the free-moving conscious house musk shrew (Suncus murinus)

Fixed feeding potentiates interdigestive gastric motor activity in rats: importance of eating habits for maintaining interdigestive MMC

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