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The effects of acute citalopram dosing on gastric motor function and nutrient tolerance in healthy volunteers.
Janssen, P, Van Oudenhove, L, Casteels, C, Vos, R, Verbeke, K, Tack, J
Alimentary pharmacology & therapeutics. 2011;(3):395-402
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Abstract
BACKGROUND It is unclear whether endogenous serotonin release is involved in the regulation of gastric motility and food intake. AIM: To study the effect of acute administration of the selective serotonin reuptake inhibitor citalopram on gastric motor function in man. METHODS Nineteen healthy volunteers underwent a gastric barostat, gastric emptying and/or a drinking test after dosing with either placebo or citalopram (20 mg intravenously). In the barostat protocol, a flaccid bag was introduced in the stomach and inflated at intra-abdominal pressure +2 mmHg, volume was recorded before and after administration of a liquid meal (300 kcal). Gastric emptying for solids and liquids was simultaneously assessed using the ¹⁴C-octanoic acid/¹³C-glycine breath test. During the drink test, volunteers drank at a rate of 15 mL/min until maximal satiation. Citalopram was compared with placebo using t-tests and mixed model analysis. RESULTS Citalopram induced a significant preprandial gastric relaxation (volume increase of 154 ± 55 mL vs. -38 ± 33 mL after placebo dosing; P < 0.05), whereas the postprandial volume increase was significantly decreased after citalopram treatment (F₁₂.₈₀ = 4.78, P < 0.0001; maximum volume increase was 304 ± 40 vs. 201 ± 54 mL after placebo and citalopram treatment respectively). Citalopram enhanced solid (123 ± 17 vs. 77 ± 6 min, P < 0.05) but not liquid emptying (62 ± 6 vs. 57 ± 4 min). Satiation scores during the drink test were lower after citalopram (F₁₉.₁₅₃ = 2.02, P = 0.01; volunteers drank 998 ± 129 vs. 765 ± 79 mL after citalopram and placebo treatment respectively). CONCLUSION The observed effects indicate a role for serotonin in the control of gastric motility and food intake.
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Influence of acute tryptophan depletion on gastric sensorimotor function in humans.
Geeraerts, B, Van Oudenhove, L, Boesmans, W, Vos, R, Vanden Berghe, P, Tack, J
American journal of physiology. Gastrointestinal and liver physiology. 2011;(2):G228-35
Abstract
Peripheral serotonin (5-hydrodytryptamine; 5-HT) is involved in the regulation of gastrointestinal motility and sensation, whereas centrally it plays a role in mood regulation. A dysfunctional serotonergic system may provide a plausible link between functional dyspepsia symptoms and its high psychosocial comorbidity such as anxiety and depression. The aim of this study was to evaluate the effect of decreased 5-HT synthesis by acute tryptophan depletion (ATD) on gastric sensorimotor function and nutrient tolerance, anxiety scores, and gastrointestinal mucosal 5-HT concentrations in healthy volunteers. All subjects were studied under a control condition and during ATD. Gastric sensorimotor function and nutrient tolerance were assessed using a barostat (n = 16, mean age 28.8 ± 1.4 yr) and a satiety drinking test (n = 13, mean age 27.3 ± 1.4 yr). Anxiety during the barostat was evaluated using State-Trait Anxiety Inventory (STAI) questionnaire. 5-HT concentrations were measured in fundic and duodenal mucosal biopsies by means of ELISA and immunohistochemistry. ATD significantly decreased plasma tryptophan levels compared with control in every experiment. ATD did not affect gastric sensitivity and compliance but decreased the sensation of nausea during balloon distension (AUC: 17.4 ± 4.3 vs. 11.4 ± 3.4 mm·mmHg, P = 0.030). ATD enhanced the postprandial volume increase (ANOVA, P < 0.05), but this was not accompanied by augmented nutrient tolerance (848 ± 110 vs. 837 ± 99 ml, nonsignificant). ATD had no effect on STAI state anxiety scores. No evidence was found for an effect on the number of enterochromaffin cells, but ATD reduced 5-HT levels in the duodenal mucosa. ATD alters gastric postprandial motor function and distension-induced nausea. These findings confirm involvement of 5-HT in the control of gastric accommodation and sensitivity.
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Utility of electrogastrography in differentiating Parkinson's disease with or without gastrointestinal symptoms: a prospective controlled study.
Chen, CL, Lin, HH, Chen, SY, Lin, SZ
Digestion. 2005;(3):187-91
Abstract
BACKGROUND/AIMS: Parkinson's disease (PD) may be associated with various gastrointestinal symptoms. This study was designed to assess the gastric myoelectrical functioning in patients with PD and in healthy controls by using electrogastrography (EGG) with the water load test and to determine the clinical utility of EGG in differentiating PD patients with or without upper gastrointestinal symptoms. METHODS Twenty patients (13 men, mean age 63 years) with PD and 11 healthy controls (5 men, mean age 55 years) were studied. The PD patients were stratified into two subgroups: 9 were assessed as PD without upper gastrointestinal symptoms (group A) and 11 as PD with upper gastrointestinal symptoms (group B). The gastric myoelectrical activity was assessed using cutaneous electrodes to record EGG before and after the subjects ingested water until full. RESULTS The PD patients drank significantly less water until full as compared with the controls (303 +/- 45 vs. 627 +/- 67 ml, p < 0.05). At baseline, the PD patients had a significantly higher 1.0- to 2.5-cpm activity as compared with the controls (44 +/- 3 vs. 33 +/- 3%, p < 0.05). These differences persisted after ingestion of the water load. The PD patients had a significantly lower 2.5- to 3.75-cpm activity late after ingestion of the water load as compared with the controls (33 +/- 4 vs. 49 +/- 5%, p < 0.05). No statistically significant differences were found in any EGG variables or the water load between the two groups of PD patients. CONCLUSIONS This study has shown that the gastric myoelectrical activity is impaired in both groups of PD patients. EGG appears to have a limited, if any, clinical utility in the differentiation of PD patients with or without upper gastrointestinal symptoms.
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Cholecystokinin and stomach distension combine to reduce food intake in humans.
Kissileff, HR, Carretta, JC, Geliebter, A, Pi-Sunyer, FX
American journal of physiology. Regulatory, integrative and comparative physiology. 2003;(5):R992-8
Abstract
The aim of this study was to test the hypothesis that gastric distension can enhance the effect of cholecystokinin (CCK) on reduction of food intake in men and women. Eight normal-weight subjects of each gender were tested four times each with either CCK or saline infusion crossed with gastric distension or no distension. Intravenous infusion of a low dose of CCK octapeptide (CCK-8; 112 ng/min for 23 min) combined with a subthreshold gastric distension induced by a water-filled balloon (300 ml) resulted in a significant (means +/- SED: 191 +/- 61 g in men, 209 +/- 61 g in women, and 200 +/- 43 g combined) reduction in intake of a liquid meal compared with saline infusion and unfilled gastric balloon. This combined effect was the result of a large and significant CCK effect when the stomach was distended (CCK vs. saline with distension: 169 +/- 43 g) and a small and insignificant distension effect (distension vs. no distension without CCK: 31 +/- 43 g). The CCK effect alone on intake (CCK vs. saline) without distension was not significant in men (72 +/- 61 g) but was significant in women (121 +/- 61 g). These results are consistent with the hypothesis that CCK's suppression of food intake is enhanced when the stomach is distended.
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Simultaneous 13C/14C dual isotope breath test measurement of gastric emptying of solid and liquid in normal subjects and patients: comparison with scintigraphy.
Chew, CG, Bartholomeusz, FD, Bellon, M, Chatterton, BE
Nuclear medicine review. Central & Eastern Europe. 2003;(1):29-33
Abstract
BACKGROUND To develop a simple method for simultaneous solid and liquid gastric emptying assessment using a dual isotope labelled breath test. MATERIAL AND METHODS 13 patients were given 100 g ground beef labelled with 25 MBq (99m)Tc sulphur colloid and 74 KBq (14)C octanoic acid, and 150 ml 10% glucose drink labelled with 8 MBq (67)Ga citrate and 150 mg (13)C acetate. 10 normal volunteers were given the same test meals but labelled with (14)C and (13)C only. Breath was collected at baseline and regularly for 4 hours. The (14)CO(2) and (13)CO(2) activity was measured with liquid scintillation counting and mass spectroscopy. The times to maximum (14)CO(2) and (13)CO(2), were determined. Comparison was made between times to maximum (14)CO(2) with scintigraphic retention of (99m)Tc at 100 minutes and times to maximum (13)CO(2) with the scintigraphic half-clearance time of (67)Ga. RESULTS For the solid meal, the times to maximum (14)CO(2) were: 60-120 minutes in the 8 patients with normal gastric emptying of (99m)Tc; 75-145 minutes for the 10 healthy volunteers; 75-180 minutes for the remaining 5 patients with abnormal gastric emptying of (99m)Tc. There was a weak but significant correlation (r = 0.56, p < 0.025) between the time to maximum (14)CO(2) and gastric retention of (99m)Tc at 100 minutes. For the liquid meal, times to maximum (13)CO(2) were: 20-35 minutes for the 4 with normal gastric emptying of (67)Ga; 15-40 minutes for the 10 healthy volunteers; 20-75 minutes for the remaining 9 patients with abnormal gastric emptying of (67)Ga. There was a strong and significant correlation (r = 0.88, p < 0.005) between times to maximum (13)CO(2) and gastric half-clearance time of (67)Ga. CONCLUSIONS Breath tests utilising test meals labelled with *C isotopes are valid alternatives to scintigraphic studies using (99m)Tc and (67)Ga for the simultaneous assessment of gastric emptying of solids and liquids.
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Gastric emptying in patients with chronic liver diseases.
Ishizu, H, Shiomi, S, Kawamura, E, Iwata, Y, Nishiguchi, S, Kawabe, J, Ochi, H
Annals of nuclear medicine. 2002;(3):177-82
Abstract
UNLABELLED There have been a number of reports of gastric emptying in cirrhosis, all with unconfirmed results. Moreover, the mechanism for delayed emptying in cirrhotic patients is unclear. We evaluated gastric emptying in patients with chronic hepatitis and cirrhosis by means of gastric emptying scintigraphy. METHODS The subjects were 18 normal controls and 75 patients with chronic viral hepatitis (50 patients had chronic hepatitis and 25 patients had cirrhosis). Tc-99m diethyltriamine pentaacetic acid labeled solid meals were used to evaluate gastric emptying; the half-time (T 1/2) of which was calculated. Digestive symptom scores were determined at the time of gastric emptying tests. RESULTS Fourteen (28%) of 50 patients with chronic hepatitis and 16 (64%) of 25 patients with cirrhosis had delayed gastric emptying. T 1/2 in patients with cirrhosis was significantly higher than that in normal controls and patients with chronic hepatitis (p = 0.0001 and 0.0003, respectively). The difference between T 1/2 in patients with chronic hepatitis and that in normal controls was not significant. On regression analysis, two indices-the serum albumin level and platelet count-were found to be significantly related to delayed gastric emptying. CONCLUSIONS Gastric emptying was more delayed in cirrhotic patients than in those with chronic hepatitis and normal controls. Delayed gastric emptying may be related to liver function and portal hypertension.
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Reproducibility of gastric myoelectrical activity and the water load test in patients with dysmotility-like dyspepsia symptoms and in control subjects.
Koch, KL, Hong, SP, Xu, L
Journal of clinical gastroenterology. 2000;(2):125-9
Abstract
Gastric dysrhythmias and normal gastric myoelectrical activity have been recorded in patients with functional dyspepsia. The aim of this study was to determine the reproducibility of gastric myoelectrical patterns and responses to a water load in patients with dysmotility-like functional dyspepsia and healthy control subjects. We studied 24 patients with dysmotility-like functional dyspepsia and 24 age-matched control subjects. Gastric myoelectrical activity was assessed using cutaneous electrodes to record electrogastrograms (EGGs) before and after the subjects ingested water until full. The EGGs with water load tests were repeated 1 week apart. The patients ingested significantly smaller volumes of water at both week 1 and 2 (358 +/- 26 mL and 349 +/- 30 mL) compared to control subjects (557 +/- 35 mL and 560 +/- 27 mL, p < 0.01). Gastric dysrhythmias were found in 4 of 24 (16.7%) control subjects at each visit and in 14 (58%) and 12 (50%) of the dyspeptic patients at week 1 and 2, respectively. Of 14 patients, 2 (14.3%) had gastric dysrhythmias at week 1 but had normal gastric rhythms at week 2. Thus, reproducibility was 100% in the control subjects and 91.7% in the patients. In conclusion, some variability in EGG pattern occurred, but gastric myoelectrical activity and responses to the water load test were generally consistent and reproducible in patients with dysmotility-like functional dyspepsia and in healthy control subjects.
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Adverse effects of whole-body vibration on gastric motility.
Miyazaki, Y
The Kurume medical journal. 2000;(1):79-86
Abstract
To investigate the response of gastric motility to whole-body vibration (WBV) exposure, electrogastrography (EGG) and gastric manometry were performed in 10 healthy male volunteers. Sinusoidal vertical vibration of three different frequencies (4 Hz, 8 Hz, and 16 Hz) with a constant vibration magnitude of 1.0 ms-2 (rms.) was randomly given to the subject seated on the platform of a vibrator for 10 min. Exposure to vibration of 4 and 8 Hz decreased the amplitude of EGG wave and of the power spectrum corresponding to a slow wave component at fasting state. Food intake (solid meal 80 g, 135 cm3, 400 kcal) enhanced gastric motility showing about 2.5-fold in the power spectrum, of which response modes during and after vibration exposure were similar to those at fasting state. The periodical manometric change around one cpm was observed during vibration exposure under the condition of food intake. Short-term exposure to WBV led to a suppression of the activity of gastric smooth muscles and affect contraction wave. These responses may result from resonance of vibration frequency as a mechanical factor and stomach contents, and increase regulation of neurohumoral factors due to vibration stress.