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Antro-pyloric contractile patterns and transpyloric flow after meal ingestion in humans.
Am J Gastroenterol. 1998 Dec; 93(12):2513-22.AJ

Abstract

OBJECTIVE

The present study aimed to evaluate the patterns of antral contractility and pylorus opening and closure in relation to transpyloric flow of a nutrient liquid meal.

METHODS

Ultrasound images of the antro-pyloro-duodenal tract were continuously tape-recorded in healthy volunteers for 1 h postprandially and were reviewed twice later by independent observers. Episodes and patterns of pylorus opening and closure, antral-wall contractions, and transpyloric flow were assessed separately and their time relations were identified.

RESULTS

Transpyloric flow (forward, 56%+/-13%; retrograde, 19%+/-11%; and to and fro, 25%+/-14%) occurred essentially during episodes of prolonged pylorus opening not associated with occlusive antral or duodenal proximal contraction, which represented the antro-pyloro-duodenal common chamber. The antro-pyloro-duodenal common chamber lasted on average 36+/-12 s and represented 41%+/-12% of the total observation period. Different patterns of antral contractions were identified according to whether they reached or occluded the terminal antrum and pylorus. Preterminal antral contractions (46%+/-12%) did not propagate beyond the proximal two thirds of the antrum. Terminal antral contractions (54%+/-12%) propagated along the entire antrum and could either occlude (20%+/-9%) or not occlude (42%+/-17%) the lumen. Pyloric opening independent of antral contractions and related to nonocclusive antral contractions could occur equally at the onset of the antro-pyloro-duodenal common chamber. Pyloric closure independent of antral contractions put an end to transpyloric flow in 73%+/-6% of the antro-pyloro-duodenal common chamber.

CONCLUSIONS

The final passage of contents from the stomach to the duodenum after the ingestion of a caloric liquid meal is the result of one or more episodes of uni- or bi-directional transpyloric flow, which are regulated by several motor events. The contractile states of the antrum and pylorus show specific features that variably interrelate to provide mixing and to regulate the transpyloric flow of ingesta. A crucial regulator of transpyloric flow appears to be the spatio-temporal relation between antral contractions and pyloric closure rather than the contractile events per se. An equal number of pyloric openings related, and unrelated, to antral contractions appears to determine the onset of the antro-pyloro-duodenal common chamber and, thus, of transpyloric flow. Pyloric closure unrelated to antral contractions appears to be the main mechanism that interrupts transpyloric flow. In conclusion, it appears that the antro-pyloro-duodenal tract acts as a functional unit in the digestion of a liquid caloric meal.

Authors+Show Affiliations

Università La Sapienza Cattedra di Gastroenterologia I, Clinica Medica II, Policlinico Umberto I, Università Campus Biomedico, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9860417

Citation

Pallotta, N, et al. "Antro-pyloric Contractile Patterns and Transpyloric Flow After Meal Ingestion in Humans." The American Journal of Gastroenterology, vol. 93, no. 12, 1998, pp. 2513-22.
Pallotta N, Cicala M, Frandina C, et al. Antro-pyloric contractile patterns and transpyloric flow after meal ingestion in humans. Am J Gastroenterol. 1998;93(12):2513-22.
Pallotta, N., Cicala, M., Frandina, C., & Corazziari, E. (1998). Antro-pyloric contractile patterns and transpyloric flow after meal ingestion in humans. The American Journal of Gastroenterology, 93(12), 2513-22.
Pallotta N, et al. Antro-pyloric Contractile Patterns and Transpyloric Flow After Meal Ingestion in Humans. Am J Gastroenterol. 1998;93(12):2513-22. PubMed PMID: 9860417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antro-pyloric contractile patterns and transpyloric flow after meal ingestion in humans. AU - Pallotta,N, AU - Cicala,M, AU - Frandina,C, AU - Corazziari,E, PY - 1998/12/22/pubmed PY - 1998/12/22/medline PY - 1998/12/22/entrez SP - 2513 EP - 22 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 93 IS - 12 N2 - OBJECTIVE: The present study aimed to evaluate the patterns of antral contractility and pylorus opening and closure in relation to transpyloric flow of a nutrient liquid meal. METHODS: Ultrasound images of the antro-pyloro-duodenal tract were continuously tape-recorded in healthy volunteers for 1 h postprandially and were reviewed twice later by independent observers. Episodes and patterns of pylorus opening and closure, antral-wall contractions, and transpyloric flow were assessed separately and their time relations were identified. RESULTS: Transpyloric flow (forward, 56%+/-13%; retrograde, 19%+/-11%; and to and fro, 25%+/-14%) occurred essentially during episodes of prolonged pylorus opening not associated with occlusive antral or duodenal proximal contraction, which represented the antro-pyloro-duodenal common chamber. The antro-pyloro-duodenal common chamber lasted on average 36+/-12 s and represented 41%+/-12% of the total observation period. Different patterns of antral contractions were identified according to whether they reached or occluded the terminal antrum and pylorus. Preterminal antral contractions (46%+/-12%) did not propagate beyond the proximal two thirds of the antrum. Terminal antral contractions (54%+/-12%) propagated along the entire antrum and could either occlude (20%+/-9%) or not occlude (42%+/-17%) the lumen. Pyloric opening independent of antral contractions and related to nonocclusive antral contractions could occur equally at the onset of the antro-pyloro-duodenal common chamber. Pyloric closure independent of antral contractions put an end to transpyloric flow in 73%+/-6% of the antro-pyloro-duodenal common chamber. CONCLUSIONS: The final passage of contents from the stomach to the duodenum after the ingestion of a caloric liquid meal is the result of one or more episodes of uni- or bi-directional transpyloric flow, which are regulated by several motor events. The contractile states of the antrum and pylorus show specific features that variably interrelate to provide mixing and to regulate the transpyloric flow of ingesta. A crucial regulator of transpyloric flow appears to be the spatio-temporal relation between antral contractions and pyloric closure rather than the contractile events per se. An equal number of pyloric openings related, and unrelated, to antral contractions appears to determine the onset of the antro-pyloro-duodenal common chamber and, thus, of transpyloric flow. Pyloric closure unrelated to antral contractions appears to be the main mechanism that interrupts transpyloric flow. In conclusion, it appears that the antro-pyloro-duodenal tract acts as a functional unit in the digestion of a liquid caloric meal. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9860417/Antro_pyloric_contractile_patterns_and_transpyloric_flow_after_meal_ingestion_in_humans_ L2 - https://Insights.ovid.com/pubmed?pmid=9860417 DB - PRIME DP - Unbound Medicine ER -