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Einar Husebye - One of the best experts on this subject based on the ideXlab platform.

  • Migrating Motor Complex in colectomized ileo stoma patients
    Basic & clinical pharmacology & toxicology, 2011
    Co-Authors: Mark Berner Hansen, Lene Wallin, Einar Husebye, Louise Dommergaard, Hans Gregersen
    Abstract:

    In colectomized patients with ileo stoma, the reflex modulation of small intestinal functions is disturbed, resulting in high enteric stoma outputs and malabsorption. Serotonin has a pivotal role in initiating Motor and secretory reflexes involving activation of neuronal 5-HT(3) and smooth muscle muscarinic receptors. We aimed to evaluate the effect of 5-hydroxytryptamine (5-HT), ondansetron and atropine on fasting and stimulated antro-duodeno-jejunal Migrating Motor Complex (MMC) in colectomized patients with ileo stoma compared with healthy subjects. Manometric recordings were obtained in a blinded, age- and gender-matched design. The effects of either standard meal or intravenous 5-HT (10 nmol/kg/min.) treatment with pre-treatment of saline (placebo) or ondansetron (250 μg/kg) or atropine (10 μg/kg) were compared. Adverse effects, blood pressure, heart rate and electrocardiographic data were also evaluated. 5-HT increased the frequency (threefold) and migration velocity (twofold) of MMC phase III in both experimental groups. Ondansetron reduced 5-HT-induced frequency of MMC phase III in patients (p 0.05). Atropine did not change fasting MMC in healthy subjects (p > 0.05). We conclude that 5-HT is a stimulator of MMC phase III and that ondansetron reduces the 5-HT-induced MMC phase III without affecting fasting or postprandial properties in colectomized patients with ileo stoma. Similar effects were observed for 5-HT and atropine in healthy subjects.

  • Stimulation of the small intestine by nutrients in relation to phase of the Migrating Motor Complex.
    Scandinavian journal of gastroenterology, 2000
    Co-Authors: Asle W. Medhus, Olav Sandstad, J. Bredesen, Einar Husebye
    Abstract:

    Background: The relationship between the preceding phase of the Migrating Motor Complex (MMC) and postprandial motility in the small intestine was studied. Methods: In eight healthy subjects small-bowel manometry was performed, and a 55-ml caloric liquid bolus (280 kJ) containing paracetamol and 14C-D-xylose was instilled into the duodenum during phase I and late phase II of the intestinal MMC, respectively, in randomized order. Blood samples were drawn at regular intervals and analysed for insulin, gastrin, glucose, paracetamol, and 14C-D-xylose. Results: After bolus administration during late phase II a phase-III-like activity succeeded by quiescence occurred in the duodenum in seven of eight subjects, whereas administration during phase I initiated irregular contractions in seven of eight subjects (P < 0.05). The caloric bolus induced a significant increase in serum insulin and gastrin. Areas under the curves for serum insulin, gastrin, glucose, paracetamol, and 14C-D-xylose were not modulated by th...

  • The influence of the Migrating Motor Complex on the postprandial endocrine response.
    Scandinavian journal of gastroenterology, 1999
    Co-Authors: Asle W. Medhus, Per M. Hellström, Olav Sandstad, E. Näslund, Einar Husebye
    Abstract:

    Background: The phase of the Migrating Motor Complex (MMC) in the proximal small intestine at meal intake modulates gastric emptying, which is accelerated after intake during phase II. In the present study the relationship between phase of the MMC at meal intake and the postprandial endocrine response was studied. Methods: Eight healthy subjects ingested a caloric liquid meal of 2020 kJ during phase I and late phase II of the intestinal MMC, respectively, in a randomized order. Blood samples were drawn at regular intervals after meal intake and analysed for insulin, gastrin, neurotensin, cholecystokinin, motilin, and somatostatin by radioimmunoassays. Results: The area under the curve (AUC) until 15 min for serum insulin (P < 0.05) and plasma neurotensin (P < 0.02) and AUC until 120 min for serum gastrin (P < 0.05) were higher after intake during late phase II than after phase I. Plasma cholecystokinin increased earlier (P < 0.05) after intake during late phase II than after phase I. Plasma mo...

Jan Tack - One of the best experts on this subject based on the ideXlab platform.

  • redefining the functional roles of the gastrointestinal Migrating Motor Complex and motilin in small bacterial overgrowth and hunger signaling
    American Journal of Physiology-gastrointestinal and Liver Physiology, 2016
    Co-Authors: Eveline Deloose, Jan Tack
    Abstract:

    During the fasting state the upper gastrointestinal tract exhibits a specific periodic Migrating contraction pattern that is known as the Migrating Motor Complex (MMC). Three different phases can be distinguished during the MMC. Phase III of the MMC is the most active of the three and can start either in the stomach or small intestine. Historically this pattern was designated to be the housekeeper of the gut since disturbances in the pattern were associated with small intestinal bacterial overgrowth; however, its role in the involvement of hunger sensations was already hinted in the beginning of the 20th century by both Cannon (Cannon W, Washburn A. Am J Physiol 29: 441-454, 1912) and Carlson (Carlson A. The Control of Hunger in Health and Disease. Chicago, IL: Univ. of Chicago Press, 1916). The discovery of motilin in 1973 shed more light on the control mechanisms of the MMC. Motilin plasma levels fluctuate together with the phases of the MMC and induce phase III contractions with a gastric onset. Recent research suggests that these motilin-induced phase III contractions signal hunger in healthy subjects and that this system is disturbed in morbidly obese patients. This minireview describes the functions of the MMC in the gut and its regulatory role in controlling hunger sensations.

  • endogenous motilin but not ghrelin plasma levels fluctuate in accordance with gastric phase iii activity of the Migrating Motor Complex in man
    Neurogastroenterology and Motility, 2015
    Co-Authors: Eveline Deloose, Inge Depoortere, Robin Vos, Maura Corsetti, Jan Tack
    Abstract:

    Background Fluctuations in motilin plasma levels have been implicated in the control of the Migrating Motor Complex (MMC). A plasma peak of motilin is present before a gastric phase III. Furthermore, not only exogenous administration of motilin but also ghrelin induces a gastric phase III in man. Aim of this study was to investigate the role of endogenous ghrelin in the regulation of the MMC. Methods Plasma samples for motilin and ghrelin were taken in between two consecutive phases III of either origin measured using high-resolution manometry. Key Results The duration of 1 complete MMC cycle was on average 95 ± 12 min. Sixty percent of the first phases III and 40% of the second phases III had a gastric origin (p = 0.0574). Motilin (p < 0.05) plasma levels differed significantly between the phases of the MMC but total and octanoylated ghrelin did not. The percentage change in motilin during the MMC was dependent on the origin of phase III (p < 0.05). Motilin levels increased on average with 35 ± 10% right before a gastric phase III and with 3 ± 4% before a duodenal phase III (p < 0.05). The percentage change in total and octanoylated ghrelin plasma levels was not affected by the origin of phase III. Conclusions & Inferences These results confirm the role of motilin but not of ghrelin as an endogenous physiological regulator of the MMC with a gastric phase III.

  • The Migrating Motor Complex: control mechanisms and its role in health and disease.
    Nature reviews. Gastroenterology & hepatology, 2012
    Co-Authors: Eveline Deloose, Pieter Janssen, Inge Depoortere, Jan Tack
    Abstract:

    The Migrating Motor Complex (MMC) is a cyclic, recurring motility pattern that occurs in the stomach and small bowel during fasting; it is interrupted by feeding. The MMC is present in the gastrointestinal tract of many species, including humans. The Complex can be subdivided into four phases, of which phase III is the most active, with a burst of contractions originating from the antrum or duodenum and Migrating distally. Control of the MMC is Complex. Phase III of the MMC with an antral origin can be induced in humans through intravenous administration of motilin, erythromycin or ghrelin, whereas administration of serotonin or somatostatin induces phase III activity with duodenal origin. The role of the vagus nerve in control of the MMC seems to be restricted to the stomach, as vagotomy abolishes the Motor activity in the stomach, but leaves the periodic activity in the small bowel intact. The physiological role of the MMC is incompletely understood, but its absence has been associated with gastroparesis, intestinal pseudo-obstruction and small intestinal bacterial overgrowth. Measuring the motility of the gastrointestinal tract can be important for the diagnosis of gastrointestinal disorders. In this Review we summarize current knowledge of the MMC, especially its role in health and disease.

Asle W. Medhus - One of the best experts on this subject based on the ideXlab platform.

  • Stimulation of the small intestine by nutrients in relation to phase of the Migrating Motor Complex.
    Scandinavian journal of gastroenterology, 2000
    Co-Authors: Asle W. Medhus, Olav Sandstad, J. Bredesen, Einar Husebye
    Abstract:

    Background: The relationship between the preceding phase of the Migrating Motor Complex (MMC) and postprandial motility in the small intestine was studied. Methods: In eight healthy subjects small-bowel manometry was performed, and a 55-ml caloric liquid bolus (280 kJ) containing paracetamol and 14C-D-xylose was instilled into the duodenum during phase I and late phase II of the intestinal MMC, respectively, in randomized order. Blood samples were drawn at regular intervals and analysed for insulin, gastrin, glucose, paracetamol, and 14C-D-xylose. Results: After bolus administration during late phase II a phase-III-like activity succeeded by quiescence occurred in the duodenum in seven of eight subjects, whereas administration during phase I initiated irregular contractions in seven of eight subjects (P < 0.05). The caloric bolus induced a significant increase in serum insulin and gastrin. Areas under the curves for serum insulin, gastrin, glucose, paracetamol, and 14C-D-xylose were not modulated by th...

  • The influence of the Migrating Motor Complex on the postprandial endocrine response.
    Scandinavian journal of gastroenterology, 1999
    Co-Authors: Asle W. Medhus, Per M. Hellström, Olav Sandstad, E. Näslund, Einar Husebye
    Abstract:

    Background: The phase of the Migrating Motor Complex (MMC) in the proximal small intestine at meal intake modulates gastric emptying, which is accelerated after intake during phase II. In the present study the relationship between phase of the MMC at meal intake and the postprandial endocrine response was studied. Methods: Eight healthy subjects ingested a caloric liquid meal of 2020 kJ during phase I and late phase II of the intestinal MMC, respectively, in a randomized order. Blood samples were drawn at regular intervals after meal intake and analysed for insulin, gastrin, neurotensin, cholecystokinin, motilin, and somatostatin by radioimmunoassays. Results: The area under the curve (AUC) until 15 min for serum insulin (P < 0.05) and plasma neurotensin (P < 0.02) and AUC until 120 min for serum gastrin (P < 0.05) were higher after intake during late phase II than after phase I. Plasma cholecystokinin increased earlier (P < 0.05) after intake during late phase II than after phase I. Plasma mo...

  • the Migrating Motor Complex modulates intestinal motility response and rate of gastric emptying of caloric meals
    Neurogastroenterology and Motility, 1995
    Co-Authors: Asle W. Medhus, J. Bredesen, O Sandstad, E Husebye
    Abstract:

    The present study elucidates whether the phase of the Migrating Motor Complex (MMC) present at the moment of food intake modulates postprandial Motor response and rate of gastric emptying of caloric meals. Eight healthy male volunteers with a mean age of 26 years were examined twice. During water-perfused gastroduodenal manometry, a liquid meal with paracetamol added as a marker was orally administered during phase I and late phase II. Paracetamol appeared in serum 14.1 +/- 3.8 min and 9.1 +/- 4.0 (mean +/- SD) min, respectively, after intake of the meal (P < 0.02). The area under the curve of s-paracetamol until 25 min after intake was 232 +/- 169 mumol l-1 min and 362 +/- 130 (P < 0.05), respectively. When taken during late phase II, a phase III-like activity occurred within 2.1 +/- 1.3 min in the duodenum, and was succeeded by quiescence. During phase I, the meal invariably initiated irregular contractions within 4 min. The phase of MMC during which a caloric meal is ingested modulates duodenal Motor response and rate of gastric emptying during the initial postprandial period. Initial postprandial Motor activity thus represents the combined effect of nutrient stimulation and the underlying enteric biorhythm as reflected by phase of MMC.

Svend Arne Pedersen - One of the best experts on this subject based on the ideXlab platform.

  • Gastric emptying in normal subjects: reproducibility and relationship to characteristics of the Migrating Motor Complex
    Neurogastroenterology & Motility, 2008
    Co-Authors: Lars S. Rasmussen, E. Øster-jørgensen, Niels Qvist, Claus Hovendal, Svend Arne Pedersen
    Abstract:

    This study was designed to clarify whether a part of the variability in gastric emptying could be ascribed to a relationship between meal ingestion and phase activity of the Migrating Motor Complex and whether reproducibility is increased when meal ingestion takes place in relation to preselected characteristics of the Migrating Motor Complex. We examined 12 healthy males, and the design included three examinations, twice with meal ingestion in a duodenal Phase I, and once in a Phase II. The meal consisted of an omelette labelled with 99mTc followed by 150 ml water labelled with 111In. The results showed that liquid lag phase (min) and was significantly shorter in Phase II than in Phase I (1 vs. 4, P = 0.007). The half emptying time of solid linear phase (min) was reproduced with nearly identical median and range values in the three series (I[1]: 67[51–87]; I[2]: 63[47–80]; 61[47–76]). With meal ingestion in Phase I a significant difference between inter- and intra-individual variance could not be demonstrated. With meal ingestion in Phase I a second examination in Phase I did not increase reproducibility of any of the variables compared to a second examination in Phase II. In conclusion, scientific investigations on gastric emptying have to be performed with phase related meal ingestion and a double-radionuclide technique.

  • The Migrating Motor Complex and the Enterohepatic Circulation of Bile Acids: A Scintigraphic Study Using 75Se-HCAT
    Neurogastroenterology & Motility, 2008
    Co-Authors: Niels Qvist, Lars S. Rasmussen, E. Øster-jørgensen, Claus Hovendal, Svend Arne Pedersen, Jens Wæver Rasmussen
    Abstract:

    The relationship between the Migrating Motor Complex (MMC) and the enterohepatic circulation was studied in 16 healthy young male volunteers using a combined technique of continuous pressure recording from the gastroduodenal region and scintigraphy with 75Se-homo-cholic-acid-taurine (75Se-HCAT). In nine subjects (group 1) the radioactive marker was instilled in the duodenum immediately before a phase III Complex of the MMC, and in seven subjects (group 2) in early phase II. In group 1, the gallbladder was visualized by scintigraphy at a median time of 45 (27–90) minutes after instillation of 75Se-HCAT. Median time for peak radioactivity in distal small intestine and in peripheral blood was 63 (36–144) minutes and 90 (63–135) minutes, respectively. The corresponding figures in group 2 were 108 (81–117), 117 (81–162), and 153 (117–180) minutes. The differences between the median values in the two groups were significant (p < 0.05). The present results demonstrate the importance of phase III in the transport of bile through the small intestine. In addition, they support the contention of jejunal absorption of cholic-acid-taurine.

  • A double-blind placebo-controlled trial of omeprazole on characteristics of the Migrating Motor Complex in healthy volunteers.
    Alimentary pharmacology & therapeutics, 2007
    Co-Authors: L. Vinter-jensen, K. Kraglund, Svend Arne Pedersen
    Abstract:

    SUMMARY The aim of the study was to investigate a possible effect of omeprazole on the characteristics of the Migrating Motor Complex. The study was performed as a double-blind crossover study and the pressure recordings were performed after 3 days of treatment with placebo or omeprazole 40 mg o.m. The calculations were based on 5 h of recording in each subject and in both investigations. There were two characteristics in the omeprazole group which were significantly different from placebo. Firstly, duodenal phase III was more often accompanied by an antral phase III and secondly, the duration of duodenal phase III was increased. The results suggest that the rapid cleaning mechanism, represented by phase III activity, is more pronounced after omeprazole treatment, possibly arising from its antisecretory effect.

  • The relationship between gut hormone secretion and gastric emptying in different phases of the Migrating Motor Complex.
    Scandinavian journal of gastroenterology, 1996
    Co-Authors: Lars S. Rasmussen, E. Øster-jørgensen, Niels Qvist, Claus Hovendal, Jens J. Holst, J. F. Rehfeld, Svend Arne Pedersen
    Abstract:

    Background: No studies are available on the relationship between the response of gut hormones and gastric emptying in different phases of the Migrating Motor Complex. This study examined whether basal gut hormone concentrations in plasma before food ingestion are predictors of emptying characteristics and whether different hormone secretion patterns are associated with specific alterations in emptying rate. Methods: Twelve healthy men were examined on two occasions: one with meal ingestion in phase I and the other with meal ingestion in phase II. The meal consisted of an omelette labelled with 99mTc followed by 150ml water labelled with 111In. Plasma concentrations of gastrin, cholecystokinin, motilin, and peptide YY were measured in the fasting state, immediately after food ingestion, and at 15-min intervals in the postprandial period. Results: New findings from the present study include a higher incremental integrated postprandial motilin response in phase I than in phase II (998 pmol/l*30 min (495 to 2...

M. J. G. Farthing - One of the best experts on this subject based on the ideXlab platform.

  • Migrating Motor Complex and sleep in health and irritable bowel syndrome
    Digestive Diseases and Sciences, 1995
    Co-Authors: D. A. Gorard, G. W. Libby, C K Vesselinovajenkins, M. J. G. Farthing
    Abstract:

    The human Migrating Motor Complex (MMC) and sleep cycle have a similar periodicity, and there is some contention as to whether these biorhythms are linked. In irritable bowel syndrome (IBS), episodes of intestinal dysmotility have been described almost exclusively during wakefulness, but IBS patients often complain of poor sleep, and it has been suggested that IBS patients have increased rapid eye movement (REM) sleep. This study sought to identify any associations between sleep stage and small intestinal motility and any objective sleep abnormalities in IBS. Nocturnal motility was recorded from six small intestinal sensors mounted on a fine nasoenteric catheter in eight IBS patients and 10 healthy volunteers. Polysomnography to determine sleep stage was recorded simultaneously. The proportions of time awake, in non-REM and REM sleep were similar in controls and IBS. REM latency did not differ between the two groups despite increased depression in the IBS patients (Hamilton Depression Rating of 8.3±1.7 in IBS, 3.0±0.7 in controls,P<0.01). Nocturnal motility was similar, with phase I occupying most of the MMC cycles. There was no temporal association between MMCs and sleep stage, with no synchrony of phase III for REM episodes. The mean motility index of 4.5±0.4 during wakefulness was greater than during all sleep stages (P<0.05). During non-REM sleep stages 1 and 2, motility index of 3.2±0.3 was greater than 2.3±0.2 during stages 3 and 4 (P<0.05), but similar to motility index of 3.3±0.4 during REM sleep. Thus, sleep architecture and nocturnal small intestinal motility are normal in IBS. In health and IBS, sleep cycles and MMC cycles are independent, but motility is quantitatively influenced by sleep stage and is inversely related to the depth of sleep.

  • Migrating Motor Complex and sleep in health and irritable bowel syndrome.
    Digestive diseases and sciences, 1995
    Co-Authors: D. A. Gorard, C. K. Vesselinova-jenkins, G. W. Libby, M. J. G. Farthing
    Abstract:

    The human Migrating Motor Complex (MMC) and sleep cycle have a similar periodicity, and there is some contention as to whether these biorhythms are linked. In irritable bowel syndrome (IBS), episodes of intestinal dysmotility have been described almost exclusively during wakefulness, but IBS patients often complain of poor sleep, and it has been suggested that IBS patients have increased rapid eye movement (REM) sleep. This study sought to identify any associations between sleep stage and small intestinal motility and any objective sleep abnormalities in IBS. Nocturnal motility was recorded from six small intestinal sensors mounted on a fine nasoenteric catheter in eight IBS patients and 10 healthy volunteers. Polysomnography to determine sleep stage was recorded simultaneously. The proportions of time awake, in non-REM and REM sleep were similar in controls and IBS. REM latency did not differ between the two groups despite increased depression in the IBS patients (Hamilton Depression Rating of 8.3±1.7 in IBS, 3.0±0.7 in controls,P