the pylorus to the duodenum; and the percentage of propagated contractions and the mean distance of their propagation in the duodenum. The major factors that delay gastric emptying are the total number, amplitude, duration, and area under contractions in the whole duodenum. Gastric emptying is delayed in several diseases, such as diabetes mellitus (5, 18, 22, 24, 30, 39), anorexia nervosa (42, 48), dystrophia myotonica (25), and functional dyspepsia (10, 15). The gastric emptying of solid meals is also delayed transiently after truncal vagotomy and pyloroplasty (8,14). Several drugs, such as cisapride, metoclopramide, and domperidone, have been proposed as gastroprokinetic agents. As a general guideline, these agents are expected to stimulate contractions in the gastropyloroduodenal area to accelerate gastric emptying. Simple stimulation of contractions, however, is not enough to accelerate gastric emptying because a cholinergic agonist, such as bethanechol chloride, or a postprandial hormone, such as gastrin, both stimulate gastric contractions; yet bethanechol has no significant effect on the rate of gastric emptying (35), whereas pentagastrin actually delays gastric emptying (9). These data suggest that a gastroprokinetic agent must stimulate specific parameters of gastropyloroduodenal contractions, such as those outlined above (21), to accelerate gastric emptying. Metoclopramide, cisapride, and
AJP - Gastrointestinal and Liver Physiology – The American Physiological Society
Published: Apr 1, 1994
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