Gastroduodenal motor activity associated with gastric emptying rate in sheep

Cutaneous gastric electrical stimulation alters gastric motility in dogs: New option for gastric electrical stimulation?

BACKGROUND AND AIM

We investigated the effects of cutaneous gastric electrical stimulation (CGES) on gastric myoelectrical activity, postprandial antral contractions and gastric tone in dogs.

METHODS

CGES was carried out via abdominal surface electrodes over the stomach. After an overnight fast, gastric slow waves were recorded from the serosal electrodes in six dogs at a frequency of 4.4 cycles/min (c.p.m.) or 10 c.p.m. Nine dogs were used for the measurement of postprandial antral contractions. Gastric tone at baseline and during CGES was measured in six of the dogs.

RESULTS

We found that: (i) CGES at 4.4 c.p.m. decreased slow wave frequency (5.1 vs 4.6 c.p.m., P < 0.05) and increased slow wave power (-6.2 vs 2.7 c.p.m., P < 0.05); CGES at 10 c.p.m. increased slow wave frequency (5.1 vs 9.2 dB, P < 0.05) and decreased normal slow waves (85.4% vs 60.0%, P < 0.05); (ii) CGES at 10 c.p.m. significantly suppressed postprandial antral contractions (P < 0.01); (iii) CGES had no effects on gastric tone.

CONCLUSIONS

CGES is capable of altering gastric slow waves and inhibiting gastric motility. It may have therapeutic potential for treating eating disorders, such as obesity. However, clinical studies are needed to explore the potential of CGES.

Quantification of distal antral contractile motility in healthy human stomach with magnetic resonance imaging

PURPOSE

To quantify healthy postprandial: 1) propagation, periodicity, geometry, and percentage occlusion by distal antral contraction waves (ACWs); and 2) changes in ACW activity in relationship to gastric emptying (GE).

MATERIALS AND METHODS

Using 1.5-T MR scanner, nine healthy fasted volunteers were examined in the right decubitus position after ingestion of 500 mL of 10% glucose (200 kcal) with 500 microM Gd-DOTA. Total gastric (TGV) and meal volumes (MV) were assessed every five minutes for 90 minutes, in and interspersed with dynamic scan sequences (duration: 2.78 minutes) providing detailed images of distal ACWs.

RESULTS

TGV increased by 738+/-38 mL after ingestion (t0), subsequently decreasing in parallel to GE. The mean GE rate and half-emptying time were 24+/-3 mL/5 minutes and 71+/-6 minutes, respectively. Accompanying ACWs reached a periodicity of 23+/-2 seconds at t35 and propagated at an unvarying speed of 0.27+/-0.01 cm/second. Their amplitude of 0.70+/-0.08 cm was constant, but the width decreased along the antral wall by 6+/-2%/cm (P=0.003). ACWs were nonocclusive (percentage occlusion 58.1+/-5.9%, t0 at the pylorus) with a reduction in occlusion away from the pylorus (P<0.001). No propagation and geometry characteristics of ACWs correlated with the changes of MV (mL/5 minutes; R2<0.05).

CONCLUSION

Our results indicate that ACWs are not imperative for emptying of liquids. This study provides a detailed quantitative reference for MRI inquiries into pharmacologically- and pathologically-altered gastric motility.

Tachygastria induced by gastric electrical stimulation is mediated via alpha- and beta-adrenergic pathway and inhibits antral motility in dogs

BACKGROUND

It is known that tachygastria is associated with gastric hypomotility and retrograde gastric electrical stimulation (RGES) delays gastric emptying and is proposed for treating obesity. The aim was to investigate the effects and mechanisms of RGES on postprandial antral contraction in dogs.

METHODS

Seven dogs were implanted with a gastric cannula and three pairs of gastric serosal electrodes. Antral contractions and gastric myoelectrical activity were recorded immediately after a solid meal, with or without RGES, or with GES on the corpus, or with RGES under administration of propranolol. The stimulus was composed of long pulses with a tachygastrial frequency.

RESULTS

(i) GES at the tachygastrial frequency impaired gastric myoelectrical activity and induced tachygastria (anovaP<0.05). (ii) GES at the tachygastrial frequency suppressed antral contractions (anovaP<0.01) and the effect was stronger with retrograde stimulation than forward stimulation (P<0.05). (iii) GES-induced tachygastria was correlated with antral hypomotility (r=-0.60, P=0.01). (iv) Propranolol and phentolamine abolished GES-induced tachygastria and antral hypomotility.

CONCLUSIONS

Long-pulse RGES at a tachygastrial frequency suppresses postprandial antral contractions, which is attributed to an induction of tachygastria via the alpha- and beta-adrenergic pathway.

Pyloric electrical stimulation reduces food intake by inhibiting gastric motility in dogs

BACKGROUND & AIMS

The pylorus plays an important role in regulating gastric emptying. The aim of this study was to investigate the therapeutic potential of pyloric electrical stimulation (PES) for obesity in dogs.

METHODS

The study was composed of 3 separate experiments. The first experiment was designed to study the effects of PES with various parameters on gastric emptying and gastric slow waves in 5 sessions. The second experiment was used to test the effects of PES on antral contractions. The acute effect of PES on food intake was studied in the third experiment.

RESULTS

(1) Pyloric myoelectrical recording showed dual frequencies. The lower frequency was identical to the frequency of the gastric slow waves, and the higher frequency was similar to that of the intestinal slow waves. (2) Gastric emptying was significantly delayed with PES, and the delay in gastric emptying was significantly and negatively correlated with stimulation energy ( r = -.673; P < .001). (3) PES significantly impaired the regularity and coupling of the intrinsic gastric myoelectrical activity in an energy-dependent manner. The delayed gastric emptying was significantly correlated with the impairment of the coupling of gastric myoelectrical activity ( r = .441; P < .02). (4) Antral contractions on the fed state were significantly and substantially inhibited with PES. (5) Acute PES significantly reduced food intake.

CONCLUSIONS

PES reduces food intake that may be attributed to its inhibitory effects on intrinsic gastric myoelectrical activity, antral contractions, and gastric emptying.

Metabolic acidosis and respiratory acidosis impair gastro-pyloric motility in anesthetized pigs

Acidosis impairs smooth muscle function in various organs. However, the effects of acidosis on the gastroduodenal tract are unknown while its dysfunction has potential perioperative harmful consequences. We investigated the effects of metabolic (MA) and respiratory acidosis (RA) on upper gut motility in tracheally ventilated pigs whose anesthesia was induced with halothane and maintained with alpha-chloralose-urethane administration (IV). Increased dead space and perfusion of hydrochloric acid 1 N (150 mL over 30 min) were used to induce RA and MA, respectively. Measurements of fundic tone using an electronic barostat, antro-pyloroduodenal phasic motility with perfused manometry and antro-duodenal electric control activity by electromyography were used to evaluate gastroduodenal function. Acidosis increased the fundic tone as reflected by a decrease in barostat volumes from 275+/-83 to 194+/-88 mL for MA and from 278+/-93 to 236+/-106 mL for RA. Pyloric and duodenal basal tones were not affected by either acidosis. A decrease in pyloric contraction amplitude from 95+/-24 to 62+/-26 mm Hg during MA and from 94+/-26 to 64+/-20 mm Hg during RA was observed. Both acidosis altered antral control activity that became dysrhythmic. Acidosis could be implicated in perioperative complications, such as gastroparesis, emesis, and regurgitation of gastric contents.

IMPLICATIONS

Metabolic and respiratory acidosis mainly affects gastric antral rhythms and has a major effect on fundic tone. Acidosis could be implicated in perioperative complications, such as gastroparesis, emesis, and regurgitation of gastric contents.

Effects of experimentally-impaired reticular contractions on digesta passage in sheep

The aim of the study was to evaluate the functional role of reticular contractions for digesta passage in sheep. Feed intake, mean retention time of fluid and plastic particles in the reticulo-rumen, rumen fluid volume, forestomach motility and particle size distribution in the faeces were determined in five rumen-fistulated sheep fed on hay ad libitum (Expt 1). The same variables were determined when reticular movements were impaired for 10 d by introducing a silicone-covered lead weight (500 g) into the reticulum (Expt 2). As feed intake dropped in Expt 2 by 27% compared with Expt 1, the sheep received in an additional experiment exactly the amount of feed which had been consumed during Expt 2 and measurements were repeated without impairing reticular movements (Expt 3). The introduction of the weight did not affect the frequency of A- or B-cycles, but elevation of the reticular floor in a cranio-dorsal direction during the biphasic contraction was markedly reduced. The pattern of marker excretion indicated a drastically changed composition of reticular outflow in Expt 2 compared with Expts 1 and 3. During Expt 2, rumen fluid volume was similar to that in Expt 1 but about 25% higher than that in Expt 3; the amount of large feed particles in the faeces was increased compared with Expt 1 (+49%) and Expt 3 (+76%). In at least two sheep, abomasal emptying was inhibited during Expt 2, as indicated by an enlarged impacted abomasum. In conclusion, the results emphasize the central role of reticular motility for the separation of particles in the forestomach, the outflow of digesta from the reticulo-rumen and transpyloric digesta flow.

Radionuclide imaging of abomasal emptying in sheep

A liquid radionuclide tracer was administered to nine sheep in order to visualise the abomasum with a gamma camera computer system. The aim was to develop a method of studying gastric emptying, with minimal surgical intervention. Oral administration of the tracer gave good images of the whole complex stomach, but quantifying abomasal emptying was not possible because of the superimposition of the stomach compartments. When the reticular groove reflex was stimulated with oral copper sulphate the radionuclide bypassed the reticulorumen, allowing quantitative analysis of abomasal activity. However, the repeatability of the reflex activation was low. Radionuclide administered directly into the abomasum produced good images of abomasal outflow and provided digital data which were analysed quantitatively. A wide range of emptying rates was observed, generally with a stepped pattern.

Duodeno-abomasal reflux in cows with abomasal displacement

The aim of this study was to investigate abomaso-duodenal digesta transport during abomasal displacement and after surgical correction of the abomasum, using intra-abomasal bile acid concentration. In healthy cows, bile acids were found in the abomasum, indicative of duodeno-abomasal reflux being a physiological event. In cows with left abomasal displacement (LDA), right abomasal displacement (RDA) and abomasal volvolus (AV), abomasal bile acid concentration was significantly higher than in healthy control cows. This was found to be true during surgery, on the first day as well as on the third day after surgery. Abomasal bile acid concentration was significantly different between LDA, RDA and AV, with LDA, RDA and AV showing lowest, intermediate and highest values respectively. In those with LDA and RDA, abomasal bile acid concentration significantly increased from surgery to first day after surgery, and decreased from first to third day after surgery. In AV cows, however, bile acid concentration declined constantly from surgery to third day after surgery. These findings indicate pathological duodeno-abomasal reflux during abomasal displacement and after surgical correction of the abomasum. Reflux seems to differ between forms of displacement (LDA < RDA < AV) and during recovery. Pathological duodeno-abomasal reflux is discussed as a consequence of functional and/or mechanical impediments on abomaso-duodenal digesta transport during abomasal displacement and after surgical correction of the abomasum.

Drugs coordinating and restoring gastrointestinal motility and their effect on selected hypodynamic gastrointestinal disorders in horses and cattle

Hypodynamic gastrointestinal disorders in horses and cattle that are thought to benefit from treatment with drugs restoring and coordinating gastrointestinal motility include postoperative ileus and large colon impaction in the horse and displacement of the abomasum and dilatation of the cecum in cattle. Important physiologic, pathophysiologic and pharmacologic mechanisms involved in the intrinsic control of gastrointestinal motility include cholinergic, adrenergic, dopaminergic, serotoninergic, and opioid-mediated pathways. Preliminary results suggest that cisapride, acting on 5-Hydroxytryptamine receptors, might be useful for treatment of idiopathic postoperative ileus and the alpha 2-adrenoceptor blocking agent yohimbine for endotoxic postoperative ileus. Naloxone, an opioid antagonist, and neostigmine, an acetylcholinesterase inhibitor, are thought to restore motility of the large colon in cases of large colon impaction in the horse. Bethanechol and neostigmine significantly increase myoelectric activity of the cecum and proximal loop of the ascending colon in healthy cows. Investigations of the effects of prokinetic drugs on displacement of the abomasum of cattle do not allow any conclusions because no results derived from controlled experimental disease models are available.

Duodenal pH dips as an index of transpyloric flow in conscious dogs

BACKGROUND

To determine if duodenal pH fluctuations might be used as a valuable index of the occurrence of gastric chyme ejection, the transpyloric flow and pH in the duodenal bulb were monitored simultaneously in six dogs.

METHODS

Transpyloric flow, monitored by a chronically implanted electromagnetic flowmeter, was represented by individual pulses of flow. Relations between the volume of these flow pulses and changes in duodenal pH were assessed both postprandially and during the increased gastric outflow that followed gastric loading of buffered saline solutions at pH 2 and 4.

RESULTS

During fasting and gastric loading with buffered saline at pH 2, no consistent relationship between flow pulses and duodenal pH fluctuations was evident. After instillation of buffer solution at pH 4 and postprandially, the magnitude of duodenal pH fluctuations became proportional to the stroke volume of the flow pulses. The removal of bile from the proximal duodenum decreased the relationship.

CONCLUSIONS

It is concluded that duodenal pH measured at 2 cm from the pylorus might be used postprandially as an index of the transpyloric flow rate of chyme.

Influence of duodenal digesta composition on abomasal outflow, motility and small intestinal transit time in sheep

1. A study was made of the influence of duodenal infusion of some of the components of the digesta on gastrointestinal motility, abomasal outflow and small intestinal transit time in seven sheep fed 1500 g grass pellets/day. Gastrointestinal motility was recorded by electromyography. Abomasal outflow was estimated according to the rate of dilution of CrEDTA injected and sampled via an abomasal catheter. Small intestinal transit time was measured by the passage of Phenol Red from the duodenum to the terminal ileum. 2. Abomasal outflow was inhibited during 3 h infusions (5 ml/min) of 100 mM-acetic, propionic, butyric and lactic acids, of 50 mM-HCl, of 0.56 M-glucose, and of 2 and 4% protein hydrolysate. Abomasal motility was inhibited by these infusions and by infusion of 234 mM-oleic acid (0.75 ml/min), of a fat emulsion (Intralipid 20% 0.3 ml/min) and of 50 mM-L-tryptophan (7.5 ml/min). 3. Abomasal motility and, where tested, abomasal outflow, were not affected by duodenal infusion of 150 mM-NaHCO3 (5-10 ml/min), 0.28 M-NaC1 (5-7.5 ml/min), distilled water (5-7.5 ml/min), 25 mM-L-tyrosine (5 ml/min), and of 50 mM-acetic, propionic, butyric and lactic acids (5 ml/min). 4. At concentrations or rates of infusion above the threshold dose needed to inhibit abomasal motility, small intestinal motility was altered and the frequency and amplitude of the reticulo-ruminal contractions were inhibited. 5. The transit time through the small intestine was increased during infusion of 100 mM-acetic, propionic, butyric and lactic acids and decreased during infusion of 0.56 M-glucose and Intralipid. 6. Inhibition of abomasal motility and outflow in sheep receiving 1500 g/day grass pellets was calculated to require increases in the duodenal concentration of volatile fatty acids of about 150% and K+ of about 38%, and to require an increase in the rate of delivery to the duodenum of H+ of about 90%, nitrogen of about 22% glucose of about 2000% and fat of about 84%. 7. These findings are discussed in relation to the composition of abomasal and duodenal digesta in sheep fed different diets. 8. It seems likely that components of duodenal chyme, such as H+, volatile fatty acids, glucose and fat only affect abomasal outflow in sheep fed high-grain diets (glucose, volatile fatty acids), or diets highly supplemented with fat (fat), for short periods after meal feeding (volatile fatty acids) or under abnormal conditions (H+).(ABSTRACT TRUNCATED AT 400 WORDS)

The effects of intake of lucerne (Medicago sativa L.) and orchard grass (Dactylis glomerata L.) hay on the motility of the forestomach and digesta flow at the abomaso-duodenal junction of the sheep

1. The relations between food intake, reticulo-ruminal motility and abomasal digesta outflow were investigated in ewes receiving lucerne (Medicago sativa) v. orchard grass (Dactylis glomerata) hay. Abomasal digesta outflow was recorded continuously by means of an electromagnetic flowmeter probe inserted into a duodenal T-shape cannula and the motility using strain-gauge force transducers. Volumes and turnover rates of both rumen and abomasal liquid phases were measured by CrEDTA dilution. 2. The voluntary intake of lucerne was higher (60%) than that of orchard grass hay, and paralleled by an increased abomasal outflow (65%) corresponding to an increased number of gushes of digesta through the flowmeter probe: 129/h instead of 78/h on orchard grass hay. Abomasal motor activity was enhanced (35%), and periods of regular spiking activity were seen passing along the duodenum at a higher velocity for the lucerne diet than for the orchard grass diet. The increased abomasal outflow with lucerne hay was associated with a higher reticulo-ruminal turnover rate, but not abomasal turnover rate. Abomasal, but not reticulo-ruminal volume, was increased (30%) when lucerne hay was fed ad lib. 3. The total number of reticulo-ruminal contractions was increased by 6.6% when the dry matter entering the duodenum was increased by 70.6%, suggesting the level of voluntary intake, rather than reticulo-ruminal motility, as a major factor governing abomasal outflow in sheep. 4. More frequent passages of digesta, unrelated to duodenal contractions, were recorded in ewes receiving lucerne compared with orchard grass. Both a higher viscosity of the contents due to the addition of guar gum and the impairment of antroduodenal motility by 5-hydroxytryptophan were able to reduce the flow rate of orchard grass digesta, but did not affect the higher flow rate of lucerne digesta. The findings suggest that the high abomasal outflow in sheep fed on lucerne ad lib. is related to a low viscosity of the contents that are propelled, even in the case of antral contractions of low magnitude.

Hyperphagia induced by pylorectomy in sheep

In the hay-fed sheep, gastric (abomasal) contents are delivered continuously into the duodenal bulb at a mean flow rate of 210 ml per hour. The pylorus could behave as the site of origin of a feedback satiety signal by acting as a distal stomach sphincter limiting the abomasal emptying rate. This ability of the pyloric sphincter was confirmed by enhancement of abomasal outflow following either pylorectomy or pyloroplasty. In both cases, the subsequent reduction of the mean residence time of digesta in the abomasum was accompanied by an increase in the voluntary intake. The increase by 48% of food intake persisted several weeks after pylorectomy and was not only compensatory for the lower intake during recovery from surgery. Such an hyperphagia, obtained by removal of the ruminant herbivore pylorus, suggests the suppression at the antroduodenal junction level of a regulating factor affecting voluntary food intake by modulating the mean residence time of digesta in the abomasum.

Duodenal bulb control of the flow rate of digesta in the fasted and fed dog

1. Continuous measurement of the flow of digesta near the pylorus, and 5 cm aborally, was assessed in the conscious dog using a chronically implanted flowmeter. The patterns of flow were related to motor activity of the gastroduodenal junction. 2. Electromagnetic measurement of the flow was calibrated in vitro by means of a pulsatile pump. Validation was obtained in vivo by direct evaluation of the amount of chyme collected from an open duodenal cannula and indirectly by a dye-dilution technique. 3. After a 12 h fast, only small amounts of gastric contents were delivered into the duodenum. This transfer occurred during periods of irregular motor activity recorded along the gastroduodenal junction, which occupied less than 25% of the recording time. The patterns of flow near the pylorus and beyond the duodenal bulb were correlated to antral and duodenal contractions respectively. 4. After a meal, gastric emptying occurred intermittently and was related to enhanced antral motor activity beyond the duodenal bulb; digesta flowed in clusters of gushes which were related to the duodenal contractions. 5. It is concluded that the mechanical role of the duodenal bulb is to change the intermittent juxtapyloric flow of digesta into a uniform flow at the duodenal level.