The Relationship between Gastrointestinal Transit and Motility in Dogs with Postoperative Ileus.

Abstract

We investigated the relationship between gastrointestinal (GI) transit and motility during postoperative ileus in dogs undergoing a single laparotomy. We combined X-ray radiography for a GI transit study with chronically implanted force transducers (FTs) for a GI motility study. Radio-opaque markers made of polyethylene and steel wires or barium sulfate were used to examine solid substance transit or liquid substance transit. For a while after the end of the operation, postoperative ileus was observed, with weak irregular contractions of the GI tract. Transmission of the contractions to the lower GI tract was then observed. The start point of interdigestive migrating contraction (IMC)-like motility was observed in the order of small intestine (I-IMC), duodenum (D-IMC), and stomach (G-IMC), and IMC proceeded gradually after the operation. The gastric emptying time of a solid marker was 73.6 +/- 2.3 h (n = 5), and depended on the time of first occurrence of G-IMC (r = 0.674, p = 0.006). The gastric emptying of the liquid marker was finished before the time of the first occurrence of G-IMC, and its small intestinal transit time correlated with the time of the first occurrence of G-IMC (r = 0.888, p = 0.018). Using combined X-ray radiography and FTs we found that recovery from postoperative ileus was aided by GI motility in which contractions were transmitted from the stomach to the lower GI tract, like IMC.

Epidural Administration of Morphine Facilitates Time of Appearance of First Gastric Interdigestive Migrating Complex in Dogs with Paralytic Ileus After Open Abdominal Surgery

“…19 Phase-III-like contractions first appeared in the ileum, followed by the jejunum, duodenum, and finally in the stomach; this pattern of recovery of interdigestive motility matched that of a previous report. 19 Moreover, phase-III-like activity in all regions of the small intestine and stomach recovered earlier postoperatively after epidural morphine. However, the postoperative IMC recorded by means of a multipressure sensor probe placed intraoperatively into the jejunum did not correlate with the first passage of flatus and stool.…”

“…[16][17][18] In particular, a previous report proved that the appearance of IMCs in the stomach (gastric IMCs or GIMCs) was correlated with both gastric emptying and small intestinal transit time. 19 The present study examined the effects of epidural analgesia on gut motility in an SGT dog model using epidural administration of saline, morphine, or ropivacaine, and compared these results with continuous intravenous injection of low-dose morphine.…”

Epidural analgesia and gastrointestinal motility after open abdominal surgery-a review

“…Reflecting intestinal paralysis, IMCs disappear during abnormal conditions such as open abdominal surgery. A previous report demonstrated that the appearance of IMC in the stomach (gastric IMC) correlated with the recovery of digestive transport (Tsukamoto et al, 1999;Shibata et al, 2002;Tanaka et al, 2004).…”

“…Eventually phase III-like contractions appear first in the ileum, followed by the jejunum, duodenum, and finally in the stomach (Tsukamoto et al, 1999;Nakayoshi et al, 2007).…”

“…As a result of severely traumatic conditions such as with major abdominal surgery, the characteristic cyclic pattern of gastrointestinal tract motility disappears. After operation, the interdigestive migrating contractions (IMC) eventually shows recovery (Tsukamoto et al, 1999;Nakayoshi et al, 2007). Clinically, temporary paralysis of the intestine is inevitable after major abdominal surgery.…”