Gastric Emptying Of Liquids Research Articles

Effect of cyclooxygenase‐2 inhibitors on gastric emptying and small intestinal transit in humans

Endogenous prostaglandins regulate smooth muscle activity; prostaglandins and cyclooxygenase (COX) inhibitors influence gastrointestinal motility in inflammatory states such as postoperative ileus in animal models. The objective of this study was to evaluate the effects of two COX-2 inhibitors on gastric emptying and intestinal transit in healthy humans. In a double-blind, placebo-controlled, parallel-group study, 66 healthy volunteers were randomized to one of two commercially available oral COX-2 inhibitors (celecoxib and rofecoxib), cisapride (positive control), or placebo. Following 7 days on therapy, study participants underwent a test of gastric emptying and small bowel transit of liquids and solids using scintigraphy. Data were analysed using Kruskal-Wallis (ANOVA on ranks)and Mann-Whitney rank sum tests. There were significant group effects on transit of solids: gastric emptying (ANOVA, P = 0.005) and small bowel transit (ANOVA, P = 0.056). However, neither COX-2 inhibitor significantly accelerated the liquid or solid gastric emptying or small bowel transit compared with placebo. The positive control, cisapride, accelerated gastric emptying of solids (post-lag slope of gastric emptying, P < 0.05), and small bowel transit of solids (t10%, P = 0.016). At maximum clinically approved dosages, celecoxib and rofecoxib have no significant effects on gastric emptying or small intestinal transit in healthy humans. Cisapride accelerates gastric emptying and small bowel transit in healthy humans.

Peptide YY(3-36) inhibits gastric emptying and produces acute reductions in food intake in rhesus monkeys.

Peptide YY3-36 [PYY(3-36)], a gastrointestinal peptide that is released into the circulation in response to ingesting a meal, has recently been suggested to play a role in controlling food intake. PYY(3-36) has been reported to inhibit food intake following peripheral administration in rodents and in human subjects. To more fully characterize the potential feeding actions of PYY(3-36), we examined the ability of a dose range of PYY(3-36) (0.3-3.0 nmol/kg) to affect liquid gastric emptying and daily 6-h food intake in male rhesus monkeys. Intramuscular PYY(3-36) produced a dose-related inhibition of saline gastric emptying that was maximal at a dose of 3 nmol/kg. Intramuscular PYY(3-36) administered before daily 6-h food access produced significant feeding reductions at doses of 1 and 3 nmol/kg. Analyses of the patterns of food intake across the 6-h period of food access revealed that PYY(3-36) increased the latency to the first meal and reduced average meal size without altering meal number. Although single doses of PYY(3-36) reduced intake, a suppressive effect on food intake was not sustained over multiple administrations across successive days. Together, these data suggest that PYY(3-36) has the ability to reduce food intake in acute test situations in nonhuman primates. Whether this is a physiological action of the endogenous peptide remains to be determined.

Effect of sex steroids on colonic distension-induced delay of gastric emptying in rats.

The objective of the present study was to examine the effect of gonadal hormones on gastric motor response to non-noxious and noxious stimuli of colonic distension. Male Wistar albino rats were used. Under ketamine anesthesia some rats underwent castration (n = 24), while the rest of the rats were sham-operated (n = 67) and divided into different groups (n = 7-8 per group). On the 15th day of surgery, liquid gastric emptying studies were commenced. Non-noxious (P < 0.05) or noxious (P < 0.01) colonic distension inhibited gastric emptying rate. Estradiol pretreatment (20 micro g/kg per day, for 5 days, s.c.) inhibited gastric motility, while estradiol pretreatment or castration of the rats prior to noxious distension prevented the delay in gastric emptying. In contrast, blockade of testosterone receptors had no effect on the delay in gastric emptying induced by either modes of distension. The results suggest that sex steroids have a modulatory role on the feedback control of gastric motility induced by noxious colonic distension.

Reliability of the [13C]‐acetate breath test in the measurement of gastric emptying of ethanol solutions: a methodological study

Background: The [13C]‐acetate breath test is a clinically well‐established test for measuring gastric emptying of liquids and correlates significantly with scintigraphy. However, no studies have been undertaken to examine the relationship between gastric emptying measured by the [13C]‐acetate breath test and ultrasonography. Furthermore, it is not known how ethanol may affect gastric emptying as measured by the [13C]‐acetate breath test. This is particularly important because of the additional steps of absorption, metabolism and exhalation of the tracer involved in the [13C]‐acetate breath test compared to the simple measurement of gastric emptying by ultrasonography. The aim of the present study was to examine the relationship between the gastric half emptying times measured by the [13C]‐acetate breath test and by ultrasonography and to determine the effect of ethanol on the comparability between both methods. Methods: On separate days, 10 healthy, fasted randomly selected subjects received the following solutions by gastric tube: 500 mL water, 4% and 10% (v/v) ethanol, 5.5% and 11.4 % (w/v) glucose. Gastric half emptying times of the test solutions were simultaneously determined using the [13C]‐acetate breath test and ultrasonography of the fundus and the antrum. Results: The gastric emptying rates determined by ultrasonography of the fundus correlated significantly with the results obtained using the [13C]‐acetate breath test for all test solutions (r = 0.64–0.92, P < 0.05 for all), whereas ultrasonography of the antrum correlated significantly with the breath test only when water (r = 0.94, P = 0.001) was used. The difference between the mean half‐emptying times obtained using the [13C]‐acetate breath test and ultrasonography of the fundus was 55 ± 1.8 min. This difference was significantly longer when 4% and 10% (v/v) ethanol solutions were given (61.2 ± 3.3 and 71.2 ± 2.9 min) compared to water (P < 0.05). Conclusions: A good correlation was found between gastric emptying as measured by the [13C]‐acetate breath test and ultrasonography of the fundus. Measurements that were obtained using the [13C]‐acetate breath test demonstrate a longer gastric half emptying time compared with those obtained using ultrasonography. This difference is even more marked when ethanol solutions are used. Presumably, this is because ethanol affects the absorption and/or the hepatic metabolism of the tracer. The [13C]‐acetate breath test is therefore not a reliable gastric emptying test for comparison of different solutions, especially when ethanol‐containing liquids are used.

Effects of gastric electrical field stimulation with long pulses on gastric emptying in dogs.

The aim was to investigate the effects of electrical field stimulation (EFS) with long and short pulses on gastric emptying, gastric contractility and vagal activity in dogs. Sixteen dogs were equipped with a duodenal cannula, electrodes and strain gauges (10 dogs) in the stomach. Each dog was fed with Ensure and gastric effluent was collected from the cannula. Electrical stimulation was applied via two electrodes (about 12 cm apart, one in the corpus and the other in the antrum) with long pulses (a frequency of 6 cycles min-1, pulse amplitude of 6 mA and width of 100 ms) in 10 dogs and with short pulses (frequency of 30 Hz and pulse width of 300 micros) in six dogs. The electrocardiogram was also recorded and heart rate variability was derived to assess the vagal activity. It was found that: (i). EFS with long pulses did not alter gastric emptying during stimulation but increased gastric emptying during the 45 min immediately after stimulation; (ii). EFS with long pulses increased gastric contractility in both proximal and distal antrum during and after the stimulation; (iii). EFS with long pulses resulted in an increase in vagal tone during the 45 min immediately after stimulation. However, there is no difference during the 45 min period of stimulation; (iv). EFS with short pulses had no effect on gastric emptying. We concluded that long pulse gastric electrical field stimulation with one electrode in the corpus and the other electrode in the antrum has postponed effects on gastric emptying of liquid, gastric contractility and vagal activity.

The addition of locust bean gum but not water delayed the gastric emptying rate of a nutrient semisolid meal in healthy subjects.

BackgroundMost of the previous studies regarding the effects of gel-forming fibres have considered the gastric emptying of liquid or solid meals after the addition of pectin or guar gum. The influence of locust bean gum, on gastric emptying of nutrient semisolid meals in humans has been less well studied, despite its common occurrence in foods. Using a standardised ultrasound method, this study was aimed at investigating if the gastric emptying in healthy subjects could be influenced by adding locust been gum, a widely used thickening agent, or water directly into a nutrient semisolid test meal.MethodsThe viscosity of a basic test meal (300 g rice pudding, 330 kcal) was increased by adding Nestargel (6 g, 2.4 kcal), containing viscous dietary fibres (96.5%) provided as seed flour of locust bean gum, and decreased by adding 100 ml of water. Gastric emptying of these three test meals were evaluated in fifteen healthy non-smoking volunteers, using ultrasound measurements of the gastric antral area to estimate the gastric emptying rate (GER).ResultsThe median value of GER with the basic test meal (rice pudding) was estimated at 63 %, (range 47 to 84 %), (the first quartile = 61 %, the third quartile = 69 %). Increasing the viscosity of the rice pudding by adding Nestargel, resulted in significantly lower gastric emptying rates (p < 0.01), median GER 54 %, (range 7 to 71 %), (the first quartile = 48 %, the third quartile = 60 %). When the viscosity of the rice pudding was decreased (basic test meal added with water), the difference in median GER 65 %, (range 38 to 79 %), (the first quartile = 56 %, the third quartile = 71 %) was not significantly different (p = 0.28) compared to the GER of the basic test meal.ConclusionsWe conclude that the addition of locust bean gum to a nutrient semisolid meal has a major impact on gastric emptying by delaying the emptying rate, but that the addition of water to this test meal has no influence on gastric emptying in healthy subjects.

A modified sonographic technique for assessment of gastric emptying of liquid.

Ultrasound scanning is replacing scintigraphy in studies of gastric emptying of liquid, but both have considerable day-to-day variability. This study describes a modified ultrasound technique for assessing gastric emptying of liquid, and evaluates the inter- and intraindividual variation in emptying time. On different days, each of 12 healthy volunteers had meals of 350 ml broth. The antral area was measured at sonography 5 times before the meal as a baseline, and every 1-4 min after the meal. The time until the antral area had decreased to 150% of baseline (T150) was determined and used as surrogate expression of gastric emptying time. The mean T150 for a broth meal was 12.6 min (range 5-21) and 13.5 min (6-23) (first and second meal, respectively). The standard deviation of the differences between the 12 pairs of repeated measurements was 3.1 min and the coefficient of variation was 24%. Ultrasound monitoring of antral size after a liquid meal is a well suited method for assessing gastric emptying of liquid.

A Modified Sonographic Technique for Assessment of Gastric Emptying of Liquid

Ultrasound scanning is replacing scintigraphy in studies of gastric emptying of liquid, but both have considerable day-to-day variability. This study describes a modified ultrasound technique for assessing gastric emptying of liquid, and evaluates the inter- and intraindividual variation in emptying time. On different days, each of 12 healthy volunteers had meals of 350 ml broth. The antral area was measured at sonography 5 times before the meal as a baseline, and every 1-4 min after the meal. The time until the antral area had decreased to 150% of baseline (T150) was determined and used as surrogate expression of gastric emptying time. The mean T150 for a broth meal was 12.6 min (range 5-21) and 13.5 min (6-23) (first and second meal, respectively). The standard deviation of the differences between the 12 pairs of repeated measurements was 3.1 min and the coefficient of variation was 24%. Ultrasound monitoring of antral size after a liquid meal is a well suited method for assessing gastric emptying of liquid.

The effect of the GABA B receptor agonist baclofen on liquid and solid gastric emptying in mice

The effect of the GABA B receptor agonist baclofen, a potential treatment for gastroesophageal reflux, on gastric emptying has not been determined. The effect of 1–4 mg/kg baclofen on liquid and solid gastric emptying in mice was evaluated by noninvasive [ 13C] breath tests. Baclofen accelerated gastric emptying of solids but delayed emptying of liquid, suggesting that it may have differential effects on proximal and distal stomach emptying.

Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia.

The relationship between functional dyspepsia and delayed gastric emptying of solids or liquids is still unclear. The aim of the present study was to investigate in dyspeptic patients the prevalence of delayed gastric emptying for solids or for liquids and to investigate the relationship to the dyspepsia symptom pattern. In 392 and 330 patients with functional dyspepsia, the solid and liquid gastric emptying, respectively, was measured using breath tests, and the severity of eight dyspeptic symptoms was scored. Gastric emptying of solids and liquids were delayed in 23% and 35% of the patients. Multivariate analysis showed that the presence of vomiting and postprandial fullness was associated with delayed solid emptying (OR 2.65, 95% CI = 1.62-4.35 and OR 3.08, 95% CI = 1.28-9.16, respectively). Postprandial fullness was also associated with the risk of delayed liquid emptying when symptom was present (OR 3.5, 95% CI = 1.57-8.68), relevant or severe (OR 2.504, 95% CI = 1.41-4.65), and severe (OR 2.214, 95% CI = 1.34-3.67). Severe early satiety was associated with the risk of delayed liquid emptying (OR 1.902, 95% CI = 1.90-3.30). A subset of dyspeptic patients has delayed gastric emptying of solids or of liquids. Delayed gastric emptying of solids was constantly associated with postprandial fullness and with vomiting. Delayed emptying for liquids was also associated with postprandial fullness and with severe early satiety.

Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia

Objectives The relationship between functional dyspepsia and delayed gastric emptying of solids or liquids is still unclear. The aim of the present study was to investigate in dyspeptic patients the prevalence of delayed gastric emptying for solids or for liquids and to investigate the relationship to the dyspepsia symptom pattern. Methods In 392 and 330 patients with functional dyspepsia, the solid and liquid gastric emptying, respectively, was measured using breath tests, and the severity of eight dyspeptic symptoms was scored. Results Gastric emptying of solids and liquids were delayed in 23% and 35% of the patients. Multivariate analysis showed that the presence of vomiting and postprandial fullness was associated with delayed solid emptying (OR 2.65, 95% CI = 1.62–4.35 and OR 3.08, 95% CI = 1.28–9.16, respectively). Postprandial fullness was also associated with the risk of delayed liquid emptying when symptom was present (OR 3.5, 95% CI = 1.57–8.68), relevant or severe (OR 2.504, 95% CI = 1.41–4.65), and severe (OR 2.214, 95% CI = 1.34–3.67). Severe early satiety was associated with the risk of delayed liquid emptying (OR 1.902, 95% CI = 1.90–3.30). Conclusions A subset of dyspeptic patients has delayed gastric emptying of solids or of liquids. Delayed gastric emptying of solids was constantly associated with postprandial fullness and with vomiting. Delayed emptying for liquids was also associated with postprandial fullness and with severe early satiety.

Rapid gastric emptying of liquids and poor mixing of milieu with digestive fluids cause long-term malnutrition after gastrectomy

Control Adwmma S Adenoma M A m L Copclnoma Number 24 13 13 16 14 Total choles. 245,5+/258.6+/teml 194,0+/-30.7 214.3+/-36.6 26.0** 29.1* 255,2+/-21.5 HDL65.7+/-29.6 65,8+/-20.3 58.4+/-19.6 65.5+/-14.5 57,6+t-14.6 cholesterol LDL108.3+/160.8+/161,9+/cholesterol 16,76 120.6+1-22.0 12.5 24,4 ~ 178.5+/-17.5* 173.3+/Trlglycedde 108,0+1-47.2 135.2+/-71.9 76.7* 138.4+/-40.5' 123.5+/.58.4 PWV 945+/-38 996+/-47* 1177+/-53 1248+/-82* 1089.,-/-68 Mean+/.Standard deviation *<0.05 **<0,01

Lactate colonic infusion delays liquid gastric emptying in humans, through an intraluminal pathway which is independent of Pyy, Glp-1 and oli

Lactate colonic infusion delays liquid gastric emptying in humans, through an intraluminal pathway which is independent of Pyy, Glp-1 and oli

Abnormalities in gastrointestinal motility are associated with diseases of oxidative phosphorylation in children.

Disorders of the mitochondrial electron transport chain enzymes of oxidative phosphorylation (OXPHOS) have neurologic, musculoskeletal, ophthalmologic, cardiac, and GI manifestations. Many adult and pediatric patients with disorders of OXPHOS have abnormalities in intestinal motility. The purpose of this study was to describe pediatric patients who initially presented with signs of GI dysmotility and were later evaluated and found to have a disorder of OXPHOS. Data were collected on six patients, including initial GI and neurologic symptoms, histology of skeletal muscle biopsies, mitochondrial DNA mutational analysis, OXPHOS enzyme assay, upper GI barium imaging, technetium-99M liquid gastric emptying scan, upper GI endoscopy, esophageal manometry, and antroduodenal manometry. All six children presented with symptoms of GI dysmotility within 2 wk of life. Patients later developed symptoms of neurologic disorders. All patients had abnormalities in OXPHOS enzyme analysis. Muscle histology showed nonspecific changes with no ragged red fibers. Sequencing of the mitochondrial DNA showed no recognized mutations. No patient had any evidence of intestinal obstruction or malrotation by upper GI barium imaging. Four patients had delayed gastric emptying. Three patients had endoscopic and histologic evidence of esophagitis. All six had demonstrable neuropathic abnormalities by antroduodenal manometry, including the following: nonpropagated antral bursts, absent migrating motor complexes, postprandial antral hypomotility, retrograde migrating motor complexes, and tonic contractions with the migrating motor complex. Abnormalities in GI motility may be an early presenting sign of disorders of OXPHOS in children.

Abnormalities in gastrointestinal motility are associated with diseases of oxidative phosphorylation in children

Objective Disorders of the mitochondrial electron transport chain enzymes of oxidative phosphorylation (OXPHOS) have neurologic, musculoskeletal, ophthalmologic, cardiac, and GI manifestations. Many adult and pediatric patients with disorders of OXPHOS have abnormalities in intestinal motility. The purpose of this study was to describe pediatric patients who initially presented with signs of GI dysmotility and were later evaluated and found to have a disorder of OXPHOS. Methods Data were collected on six patients, including initial GI and neurologic symptoms, histology of skeletal muscle biopsies, mitochondrial DNA mutational analysis, OXPHOS enzyme assay, upper GI barium imaging, technetium-99M liquid gastric emptying scan, upper GI endoscopy, esophageal manometry, and antroduodenal manometry. Results All six children presented with symptoms of GI dysmotility within 2 wk of life. Patients later developed symptoms of neurologic disorders. All patients had abnormalities in OXPHOS enzyme analysis. Muscle histology showed nonspecific changes with no ragged red fibers. Sequencing of the mitochondrial DNA showed no recognized mutations. No patient had any evidence of intestinal obstruction or malrotation by upper GI barium imaging. Four patients had delayed gastric emptying. Three patients had endoscopic and histologic evidence of esophagitis. All six had demonstrable neuropathic abnormalities by antroduodenal manometry, including the following: nonpropagated antral bursts, absent migrating motor complexes, postprandial antral hypomotility, retrograde migrating motor complexes, and tonic contractions with the migrating motor complex. Conclusion Abnormalities in GI motility may be an early presenting sign of disorders of OXPHOS in children.

Delayed liquid gastric emptying induced by electric stimulation of small intestine depends on nitric oxide pathway in conscious dogs

pressure in the 1200 ml balloon was raised by 3 mmHg/min from 1 mmHg to 12 mmHg (ramp phase) and was kept at this level tor 5 rain (tonic: phase), Adaptive accommodation during the toinc phase is the intragastric volume increase attained during the tonic phase, Maximum accommodation capacity is the rate of volume increase (ml/s) in the tonic phase. At'commodatinn time is the time from the start of the tonic phase to the end of adaptive accommodation. The volume response was investigated in each individual on two separate days, once during fasting conditions and once following 200 ml of a liquid meal (Nutridrink | 200 kcal/200 ml) given 15 min before the start of the distension. Results: In response to the test meal, healthy controls had a signibcant increase in maximum gastric volume (from 428-+ 60 to 734 _+ 31 ml, p = 0.0005), adaptive accommodation during tonic phase (from 223 -+ 37 to 435 -+ 41 ml, p = 0002), and in accomnmdation time (from 91 _+ i4 to 190 -+ 23 s, p = 0.003) The test meal had, hm,vever, no efi~.'ct on maximum accommodation capacity (2.4-+0,4 vs. 23_+0.2 mL/s, p=0+8) The most pronounced difi'erences between health3, controls and patients with tunctiona| dyspepsia were seen during lasting: adaptive accommodation during tonic phase (223-+ 37 ml in healthy persons and 132 -+ ]9 ml in patients, p = 004) and maximum accommodation capacity (2.4 _+ 0.4 vs. 0.8 _+ 0.1 ml/s, p = 0.0009), After tbe meal, there were no sigmficant differences between the groups. In patients with diabetes, the most pronounced difterences were seen after the meal: adaptive accommodation during the tonic phase (435 -+ 41 ml in heahhy controls vs. 274_+ 51 ml in diabetics, p = 0+03)+ Using these relatively low pressures the symptom scoring was inconsistent. Conclusion: This barostat technique allows detailed analysis of the gastric volume responses, Patients with functional dyspepsia and healthy controls differed significantly during lasting conditions concerning the rate and extent of adaptive accommodation during the tonic phase of distenmon, Diabetics, however, differed from controls mainly in adaptive accommodation during the tonic phase of distension after a meal.

Effect of solid meal on gastric emptying of, and glycemic and cardiovascular responses to, liquid glucose in older subjects.

Gastric emptying is a determinant of the postprandial glycemic and cardiovascular responses to oral carbohydrate. We evaluated the effects of a solid meal on gastric emptying and the glycemic and cardiovascular responses to oral glucose in healthy older subjects. Ten subjects aged 72.1 +/- 1.9 yr were studied. Each subject had measurements of gastric emptying, blood glucose, serum insulin, blood pressure, and heart rate after ingestion of a 50-g glucose drink (300 ml) with (mixed meal) or without (liquid only) a solid meal (300 g ground beef). Gastric emptying of liquid was initially slightly more rapid (P < 0.05) after the mixed meal compared with liquid only at 5 min (92.0 +/- 1.5 vs. 96.0 +/- 1.3%) and much slower (P < 0.05) after 120 min. The time to peak blood glucose was less (39.0 +/- 4.0 vs. 67.5 +/- 10.3 min; P < 0.01) and blood glucose subsequently lower (P < 0.01) after the mixed meal. The increase in serum insulin was greater (P < 0.001) after the mixed meal. Blood pressure fell (P < 0.05) in the first 30 min, with no difference between the two meals. Increase in heart rate after both meals (P < 0.005), was greater (P < 0.05) after the mixed meal. The presence of a noncarbohydrate solid meal had discrepant effects on early and subsequent emptying of a nutrient liquid, which affects postprandial glycemia and increased heart rate.

Gastric Electrical-Stimulation Effects on Canine Gastric Emptying, Food Intake, and Body Weight

It has been reported that electrical stimulation at the distal stomach can disrupt intrinsic gastric electrical activity and delay gastric emptying. Gastric dysrhythmia and impaired gastric emptying are associated with upper gastrointestinal symptoms and weight loss. The purpose of this study was to evaluate the effect of low-frequency/long-pulse gastric electrical stimulation (GES), at proximal and distal stomach, on canine gastric emptying, food intake, and body weight. Eight dogs were surgically implanted with four pairs of electrodes along the greater curvature and a gastric tube at the dependent part of the stomach. Liquid gastric emptying at baseline, during proximal and distal GES at 6 cycles per minute, was assessed first by a dye dilution technique. Proximal and distal GES were then randomly delivered during feeding for 10 consecutive days, and food intake and body weight were recorded daily. There was no significant difference in gastric emptying parameters among the various sessions. The mean daily food consumption was significantly reduced during both sessions of GES, resulting in significant immediate weight loss. Percentage weight loss was comparable between both sessions of GES. Short-term GES significantly reduced canine food intake and weight. This effect may not be related to changes in gastric emptying. GES may have a potential role in the treatment of obesity.

Gastric emptying of liquids is delayed by co-ingesting solids: a study using salivary paracetamol concentrations.

Paracetamol concentrations in plasma, a frequently used index of gastric emptying (GE) of liquids, are closely correlated with those in saliva. GE of liquids is delayed by co-ingesting solids. No researchers have used salivary paracetamol concentrations to show this phenomenon. The aim of this study was to elucidate whether salivary paracetamol concentrations can detect the food-induced delay in liquid GE. Paracetamol absorption was measured twice in five healthy male volunteers. Following an overnight fast, they received 10 mg/kg paracetamol in 200 ml water alone on one occasion, and received this solution after consuming a 400 kcal-containing cookie on another occasion. After thorough rinsing of the month, 1 ml saliva was obtained, simultaneously with 2 ml blood, at 0, 0.25, 0.5, 0.75, 1.0, 2.0, 3.0, 4.0, and 6.0 h after paracetamol intake. The peak concentration (C(max)), the time to C(max) (t(max)), the area under the curve (AUC), and C(max)/AUC in plasma were calculated. Salivary C(max) and t(max) were also determined. Plasma C(max) and AUC were not significantly different between the two occasions. In contrast, significant differences in plasma t(max) and C(max)/AUC ( P < 0.05) established the food-induced delay in GE. Salivary t(max) could detect the delayed GE, whereas salivary C(max) could not. Salivary t(max) can document the solid meal-induced delay in liquid GE.

Effect of cholecystokinin-A receptor blockade on postprandial insulinaemia and gastric emptying in humans.

Our aim was determine the relationship between cholecystokinin (CCK)-A receptor blockade, glucose levels, insulin secretion and gastric emptying in humans, and to assess the effect of CCK-A blockade on pancreatic polypeptide secretion. After a 12-h fast, six healthy volunteers were given [99mTc]iminodiacetic acid monosodium salt (IDA) intravenously (5 mCi). One hour later they were offered a 577 kcal liquid meal containing [99mTc]diethylenetriaminepentaacetic acid (DTPA) (2 mCi) and glucose (105 g). Scintigraphic gastric and gallbladder activity, and plasma glucose, insulin and pancreatic polypeptide responses were monitored. In a second experiment, a continuous intravenous infusion of loxiglumide (7.5 mg kg h(-1)) was started 60 min before and continued until 120 min after test meal ingestion to block the CCK-A receptors. Gallbladder emptying was blocked by loxiglumide. Loxiglumide accelerated gastric emptying, increased insulin secretion without alteration of glucose profiles, and abolished all phases of the postprandial pancreatic polypeptide response. Blockade of peripheral CCK-A receptors accelerates gastric emptying of liquids with an increase in postprandial insulin levels. The lack of changes in glycaemia suggests that alternative homeostatic mechanisms also control postprandial glucose levels. Inhibition of pancreatic polypeptide release may reflect an independent effect of loxiglumide on vagal control involved in pancreatic polypeptide release.