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Antroduodenal motility and small bowel transit during continuous intraduodenal or intragastric administration of enteral nutrition
Author(s) -
M. Ledeboer,
Ad Masclee,
Minneke J. Coenraad,
J. van der Vecht,
I. Biemond,
C. B. H. W. Lamers
Publication year - 1999
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.1999.00507.x
Subject(s) - medicine , motility , migrating motor complex , enteral administration , cholecystokinin , endocrinology , peptide yy , parenteral nutrition , pancreatic polypeptide , duodenum , gastroenterology , small intestine , gastrointestinal tract , gastrointestinal hormone , hormone , biology , peptide hormone , neuropeptide , glucagon , neuropeptide y receptor , receptor , genetics
Background Gastrointestinal intolerance is observed more frequently during intraduodenal (ID) tube feeding than during intragastric (IG) feeding, possibly because it evokes a stronger gastrointestinal response and accelerates small bowel transit. We have investigated whether the accelerated small bowel transit during ID feeding results from alterations in antroduodenal motility pattern. Design The effect of IG and ID infusion of a polymeric diet (Nutrison, 125 kcal h −1 ) on antroduodenal motility, small bowel transit time (SBTT) and gastrointestinal hormone release was studied in nine healthy subjects. These subjects were studied on three occasions for 6 h during fasting, continuous IG or ID feeding. Results Phase III recurrence time was significantly prolonged during IG feeding compared with fasting (240 ± 51 vs. 136 ± 24 min; P < 0.05). None of the subjects had recurrence of phase III during ID feeding; the fed motor pattern remained present. Parameters of fed motility (mean amplitude and motility index) were not significantly different between IG and ID feeding, although the frequency of antral and duodenal contractions was lower during ID than during IG feeding. SBTT was significantly accelerated during ID compared with IG feeding and with fasting (58 ± 8 vs. 73 ± 9 and 83 ± 10 min respectively; P < 0.05). Plasma cholecystokinin (CCK) and pancreatic polypeptide (PP) levels were significantly higher during ID than during IG feeding. Peptide YY (PYY) levels were significantly higher during ID than during fasting, but not during IG feeding Conclusions During intraduodenal feeding, a fed motility pattern is preserved, whereas during intragastric feeding transition from a fed to a fasting motor pattern is observed in over 50% of the subjects. These differences may be related to augmented hormone release during intraduodenal feeding.