Role and integration of mechanisms controlling gastric emptying

M Horowitz, J Dent, R Fraser, W Sun… - Digestive diseases and …, 1994 - Springer
M Horowitz, J Dent, R Fraser, W Sun, G Hebbard
Digestive diseases and sciences, 1994Springer
The mechanical factors responsible for normal gastric emptying are still poorly understood,
largely because of the technical difficulties associated with the measurement of potentially
relevant gastric and small intestinal mechanisms in humans. It would be surprising if
patterns of gastroduodenal motility and transpyloric flow were not complex and highly
variable: ingested food must be stored, mixed with secretions, ground into small particles,
and delivered in a" liquefied" form into the duodenum, at a rate that allows efficient digestion …
The mechanical factors responsible for normal gastric emptying are still poorly understood, largely because of the technical difficulties associated with the measurement of potentially relevant gastric and small intestinal mechanisms in humans. It would be surprising if patterns of gastroduodenal motility and transpyloric flow were not complex and highly variable: ingested food must be stored, mixed with secretions, ground into small particles, and delivered in a" liquefied" form into the duodenum, at a rate that allows efficient digestion and absorption. The intragastric distribution of ingesta and gastric emptying should be predictable from a knowledge of the temporal and spatial organization of the pressure and volume accommodating mechanisms in the stomach and proximal small intestine. The optimal approach to understanding the mechanics of gastric emptying should therefore be to perform concurrent recordings of gastropyloroduodenal pressures, wall motion generated by muscular contractions, intragastric distribution of food, and both transpyloric and intragastric flow on a second by second basis. Such studies have not been performed in humans to date because of methodological limitations. Although it is clear that the motor functions of the proximal stomach, antrum, pylorus, and duodenum are closely related, the emphasis of most studies has been to attempt definition of the role of individual motor components. Only a few technically adequate studies have attempted to relate patterns of
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