Differences In Gastric Emptying Research Articles

Gastric emptying with gastro-oesophageal reflux.

The time taken for gastric emptying of a liquid (milk) or a semi-liquid (pudding) meal was evaluated in 477 infants and children. These patients were referred for suspected gastro-oesophageal reflux and underwent gastro-oesophageal scintigraphy, prolonged oesophageal pH study, manometric evaluation of the lower oesophageal sphincter pressure, and fibreoptic endoscopy. No difference in gastric emptying was observed in children aged under 3 years, regardless of the presence or absence of the gastro-oesophageal reflux, the pressure of the lower oesophageal sphincter, or the presence of oesophagitis. In children over 6 years, however, gastric emptying was significantly delayed in those presenting with reflux compared with those without reflux; in children over 3 years there was slower gastric emptying in those with a decreased lower oesophageal sphincter pressure compared with those with higher pressure and in those with overt oesophagitis compared with those without oesophagitis. This study suggests that gastro-oesophageal reflux is more severe in childhood than in infancy, probably due to more complex motor disorders affecting the gastric fundus as well as lower oesophageal sphincter function.

GASTRODUODENAL MOTILITY IN NEONATES: RESPONSE TO HUMAN MILK COMPARED TO COW-MILK FORMULA

It is known that breast milk empties more quickly from the stomach than does cow milk formula. We studied the difference in post-prandial gastroduodenal contractions between neonates fed with human milk and those fed with formula. Twenty-four 5-36 day-old neonates were tested. Changes in luminal pressure in the gastric antrum and duodenum were recorded manometrically for 3 h. In all cases, repetitive, high amplitude non-migrating contractions were the dominant wave form during the postprandial period. The number of episodes, duration, amplitude, and frequency of non-migrating contractions were not different following the different feedings. Bursts of non-migrating contraction were 4 times more common in the duodenum (6.9±1.6 episodes/h) than in the antrum (1.8±0.9 episodes/h) (p<0.05), but an average episode lasted 3 times longer in the antrum (1.6±0.2 min vs 4.1±0.8 min, p<0.05). Non-migrating contractions had frequencies identical to those found in phase 3 of the MMC: 3-5/min in the antrum, and 11-13/min in the duodenum. The migrating myoelectric complex, which signals a return to the interdigestive (fasting) state, appeared in 15% of breast milk-fed infants, but in only 171 of formula-fed infants (p<0.05). Because contractions were similar following the two meals, but a fasting state recurred more rapidly in breast milk-fed infants, we conclude phasic, non-propagated antroduodenal contractions do not mediate differences in gastric emptying.

Gastric emptying of liquids in normal subjects and patients with healed duodenal ulcer disease.

We have characterized the dose-response of inhibition of gastric emptying by acid, glucose, and fat in duodenal ulcer (DU) patients and normals (N) matched by age and sex. Gastric emptying was measured by the George technique while intragastric pH was maintained constant by intragastric titration. Acid, glucose, and fat inhibited gastric emptying in a dose-dependent fashion in both groups. DU patients emptied all three types of meals faster than normals, but differences were only seen at the lower doses of glucose or with the less potent doses of acid and fat. With low concentrations of glucose and at all concentrations of acid, DU patients emptied the meals faster than normals only in the first 5 min; but with fat the differences persisted throughout the 30-min test. Differences in gastric emptying of liquid meals in DU patients vs normals are small, and they occur with nutrient as well as acid meals. The variable responses obtained with the different concentrations may explain the inconsistencies found by other workers.

Gastric emptying of hypertonic glucose in diabetes mellitus and duodenal ulcer.

Gastric emptying of hypertonic glucose liquid meals was studied in diabetes, duodenal ulcer, and hospitalized controls by means of the 10% glucose 30-minute test meal, with phenol red as nonabsorbable marker. Acid secreted into the meal was measured. Results revealed no significant difference in gastric emptying between controls and patients with duodenal ulcer and diabetes mellitus. Among diabetics, some individuals empty this meal more rapidly than normal. The results show that alterations of gastric emptying cannot account for the late peaks observed on oral glucose tolerance tests in diabetics, nor for any tendency toward reactive hypoglycemia in duodenal ulcer. They suggest that autovagotomy may occur in some diabetics.

Influence of Microorganisms on Intestinal Absorption: Oleic Acid 131I and Triolein 131I Absorption by Germfree and Conventionalized Rats

Several differences in lipid metabolism have been demonstrated between germfree and conventional rats. To evaluate the role which intestinal absorption might play in determining these differences, we compared the absorption of oleic acid 131I and triolein 131I in germfree and conventionalized rats. Gastric emptying of both compounds appeared to be delayed in germfree rats and correspondingly less radioactivity reached the cecum during the 6-hour period following intragastric administration. When corrections were made for differences in gastric emptying, germfree and conventionalized rats absorbed oleic acid and triolein at similar rates. Under the conditions of our studies, intestinal microorganisms did not appear to influence the rate of either lipolysis or fatty acid absorption directly, but significantly influenced the rate at which fat was transported along the gastrointestinal tract.