Abstract

The relaxation mechanism of the pyloric smooth muscle is largely dependent on a nonadrenergic noncholinergic (NANC) inhibitory innervation mediated in part by nitric oxide (NO). The aim of the present study was to investigate the effect of NO antagonists on the contractility of the pyloric smooth muscle. In the clinical trial, 10 anesthetized experimental rabbits were infused intraarterially with the NO synthesis inhibitor N-nitro- l-arginine ( l-NNA), at a concentration of 10 −4 mol/L; 10 controls received normal saline intraarterially. Pyloric contractility was assessed by balloon manometry. l-NNA infusion produced a dose-dependent increase in the frequency of the pyloric contraction. The maximal increase in frequency occurred during the slow l-NNA infusion rate of 146 ng/min (baseline-adjusted frequencies of experimental v control: 1.267 ± 0.389 v 0.632 ± 0.375; P = .001). The increased frequency level was sustained over the subsequent fast infusion rate of 292 ng/min (experimental v control: 1.362 ± 0.604 v 0.704 ± 0.579; P = .022). Both the duration and the amplitude of the pyloric contractions were not affected by the l-NNA infusion. These findings suggest that blockage of the l-arginine-NO pathway may have resulted in inhibition of the NANC-induced gastric muscle and relaxation of the pyloric sphincter. The authors speculate that the decreased NO production may be responsible for the sustained contraction of the pyloric smooth muscle with secondary hypertrophy, characteristic of hypertrophic pyloric stenosis.

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