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Post‐prandial and interdigestive return of bile acids to the gallbladder in healthy subjects
Author(s) -
QVIST N.,
ØSTERJØRGENSEN E.,
PEDERSEN S. A.,
RASMUSSEN L.,
HOVENDAL C.
Publication year - 1993
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/j.1365-2982.1993.tb00120.x
Subject(s) - migrating motor complex , ingestion , gallbladder , gastroenterology , medicine , duodenum , meal , postprandial , enterohepatic circulation , scintigraphy , motility , endocrinology , bile acid , biology , insulin , genetics
The enterohepatic circulation of a radioactive marked bile acid ( 75 Se‐HCAT) was studied by scintigraphy in the post‐prandial period as well as after prolonged fasting in healthy young male volunteers in combination with a continuous pressure recording from the antroduodenal region. In a group of 8 subjects the radioactive marker was instilled into duodenum after the ingestion of a standard meal. At the transition from fed‐motility pattern (irregular contractions with a frequency of 1–9 per minute) to fasting intestinal motility pattern, defined as the occurrence of a Phase HI activity‐front of the migrating motor complexes, a median (range) of 14% (9–25%) of the 75 Se‐HCAT pool was stored in the gallbladder. During the following migrating motor complex cycles, net gallbladder filling occurred with a significantly higher rate during Phase I (0.22% of the 75 Se‐HCAT pool per minute) compared to Phase II, where the median net value was 0.07%. This difference in net filling rate was due to the occurrence of periods of gallbladder emptyings during Phase II. At the end of this first migrating motor complex cycle in the post‐prandial period a total of 32% (26–46%) of the 75 Se‐HCAT pool was in the gallbladder. In another group of 8 subjects the scintigraphic study was not carried out until 15–20 hours after ingestion of the standard meal and the radioactive marker. The scintigraphic study was carried out for two subsequent migrating motor complex cycles, and the amount of the 75 Se‐HCAT pool present in the gallbladder at the first recorded Phase III complex was 46% (32–52%). The figures at the occurrence of the following two Phase III complexes were 48% (32–65%) and 47% (42–59%), respectively. A cyclic variation in gallbladder filling and emptying in connection with the migrating motor complex cycle was seen with a net filling during Phase I and a net emptying during Phase II. In the study after prolonged fasting the number and duration of the spontaneous gallbladder emptyings in Phase II were not different from those in the post‐prandial study. However, the amount emptied in per cent of the 75 Se‐HCAT pool was significantly higher in the group studied after prolonged fasting compared to the group studied in the postprandial period, and accounted for a median of 3.3% (2.0–16.5%) and (1.6–6.0%) of the 75 Se‐HCAT pool, respectively. This difference is most likely due to an increase in the concentration of gallbladder bile during fasting.