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Pharmacological modulation of gut mucosal and large vessel blood flow
Author(s) -
KAMM M. A.,
JORDAN C. C.,
LEAKER B. R.,
NICHOLSON F. B.,
MURRAY C. D. R.,
TAYLOR S.,
MARSHALL M.,
GIBBS A.,
CARTER E. G.,
EMMANUEL A. V.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03256.x
Subject(s) - medicine , blood flow , splenic flexure , gastroenterology , anesthesia , colonoscopy , colorectal cancer , cancer
Summary Background Constipation, diminished gut blood flow, ischaemic colitis and drug therapy may be associated. Aim To study the effect of constipating medication on, and the regulation of, gut blood flow. Methods 24 healthy females (mean age 30) received, in a double‐blind, three‐way crossover study: (i) placebo, (ii) ipratropium 40 μg by inhalation (positive control known to reduce rectal mucosal blood flow) and (iii) oral loperamide 4 mg. Mucosal blood flow was measured at the splenic flexure and rectum using laser Doppler flowmetry. Blood flow in the superior and inferior mesenteric arteries was measured by trans‐abdominal Doppler ultrasound. Results Ipratropium decreased rectal mucosal blood flow by 16% ( P = 0.009) and splenic flexure mucosal blood flow by 8% ( P = 0.075). Loperamide caused no change in rectal ( P = 0.40) or splenic flexure mucosal blood flow ( P = 0.73). Neither treatment changed superior or inferior mesenteric artery blood flow. Splenic flexure mucosal blood flow showed a positive correlation with rectal mucosal blood flow ( r = 0.69; P < 0.0001). Conclusions Vasoactive agents may reduce gut mucosal blood flow in the absence of reduced large vessel flow. Constipating drugs do not necessarily reduce gut blood flow. Rectal mucosal blood flow correlates with splenic flexure mucosal flow, and potentially may be used as a more convenient surrogate for studying splenic flexure blood flow.