Skip to main content
NCBI home page
Gut logoLink to Gut
. 1988 Aug;29(8):1042–1051. doi: 10.1136/gut.29.8.1042

Further characterisation of the 'ileal brake' reflex in man--effect of ileal infusion of partial digests of fat, protein, and starch on jejunal motility and release of neurotensin, enteroglucagon, and peptide YY.

R C Spiller 1, I F Trotman 1, T E Adrian 1, S R Bloom 1, J J Misiewicz 1, D B Silk 1
PMCID: PMC1433910  PMID: 3410330

Abstract

Previous studies have shown that ileal infusion of partially digested triglyceride inhibits jejunal motility. The partial digest used in those studies contained a mixture of glycerol, free fatty acid, mono-, di-, and triglycerides. In Part I of the present study we have separately infused emulsions containing either glycerol 3.1 g (n = 6), oleic acid 9.6 g (n = 6), triolein 10 g (n = 12), or medium chain triglycerides 10 g (n = 6) into the ileum and have recorded the effect this has on jejunal motility. Five further subjects received infusions of partial hydrolysates of corn starch 10 g and lactalbumin 7 g. Marked inhibition of jejunal pressure wave activity was seen after all three lipid infusions, per cent activity falling from a control of 37.7 (7.7) to 6.2 (2.1) and 22.4 (8.2)% 30 min after completing the oleic acid and triolein infusions respectively, and from a control value of 39.5 (4.1) to 17.7 (4.7) after MCTs (all p less than 0.05). No significant fall occurred after infusion of glycerol, protein or carbohydrate. All three lipid infusions raised plasma concentrations of neurotensin, enteroglucagon and peptide YY equally effectively, although only the rise in peptide YY correlated significantly with the inhibition of jejunal pressure wave activity (r = 0.80, n = 6, p less than 0.05). In Part II of this study six subjects received a 3 ml/min jejunal infusion of an isotonic carbohydrate saline solution followed after three hours by a similar infusion of a partial digest of lipid. During each infusion flow and transit time was measured by marker and dye dilution. Jejunal infusion of the carbohydrate-saline solution was associated with low jejunal flow, 4.7 (1.0) ml/min and a mean transit time through the 50 cm study segment of 36.5 (7.1) min. By contrast jejunal infusion of partially digested triglyceride was associated with a markedly increased flow, 9.0 (1.2) ml/min, a fall in mean transit time to 20.3 (2.6) min and significant rises in pancreaticobiliary secretions. Jejunal triglyceride also increased the incidence of prolonged high amplitude jejunal pressure waves in four of six subjects. These studies suggest that there are important differences in the jejunal response to ileal versus jejunal lipid. While long and median chain free fatty acids infused into the ileum exert an inhibitory effect on jejunal motility, when infused directly into the jejunum partially digested triglyceride accelerates transit, increases jejunal flow and subtly alters the pattern of jejunal contractions.

Full text

PDF
1042

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adrian T. E., Ferri G. L., Bacarese-Hamilton A. J., Fuessl H. S., Polak J. M., Bloom S. R. Human distribution and release of a putative new gut hormone, peptide YY. Gastroenterology. 1985 Nov;89(5):1070–1077. doi: 10.1016/0016-5085(85)90211-2. [DOI] [PubMed] [Google Scholar]
  2. Adrian T. E., Savage A. P., Bacarese-Hamilton A. J., Wolfe K., Besterman H. S., Bloom S. R. Peptide YY abnormalities in gastrointestinal diseases. Gastroenterology. 1986 Feb;90(2):379–384. doi: 10.1016/0016-5085(86)90936-4. [DOI] [PubMed] [Google Scholar]
  3. Allen J. M., Fitzpatrick M. L., Yeats J. C., Darcy K., Adrian T. E., Bloom S. R. Effects of peptide YY and neuropeptide Y on gastric emptying in man. Digestion. 1984;30(4):255–262. doi: 10.1159/000199117. [DOI] [PubMed] [Google Scholar]
  4. Ammon H. V., Thomas P. J., Phillips S. F. Effects of oleic and ricinoleic acids on net jejunal water and electrolyte movement. Perfusion studies in man. J Clin Invest. 1974 Feb;53(2):374–379. doi: 10.1172/JCI107569. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Blackburn A. M., Bloom S. R. A radioimmunoassay for neurotensin in human plasma. J Endocrinol. 1979 Nov;83(2):175–181. doi: 10.1677/joe.0.0830175. [DOI] [PubMed] [Google Scholar]
  6. Blackburn A. M., Fletcher D. R., Bloom S. R., Christofides N. D., Long R. G., Fitzpatrick M. L., Baron J. H. Effect of neurotensin on gastric function in man. Lancet. 1980 May 10;1(8176):987–989. doi: 10.1016/s0140-6736(80)91434-8. [DOI] [PubMed] [Google Scholar]
  7. Bo-Linn G. W., Fordtran J. S. Fecal fat concentration in patients with steatorrhea. Gastroenterology. 1984 Aug;87(2):319–322. [PubMed] [Google Scholar]
  8. Booth C. C., Read A. E., Jones E. Studies on the site of fat absorption: 1. The sites of absorption of increasing doses of I-labelled triolein in the rat. Gut. 1961 Mar;2(1):23–31. doi: 10.1136/gut.2.1.23. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fields M., Duthie H. L. Effect of vagotomy on intraluminal digestion of fat in man. Gut. 1965 Jun;6(3):301–310. doi: 10.1136/gut.6.3.301. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Ghatei M. A., Uttenthal L. O., Christofides N. D., Bryant M. G., Bloom S. R. Molecular forms of human enteroglucagon in tissue and plasma: plasma responses to nutrient stimuli in health and in disorders of the upper gastrointestinal tract. J Clin Endocrinol Metab. 1983 Sep;57(3):488–495. doi: 10.1210/jcem-57-3-488. [DOI] [PubMed] [Google Scholar]
  11. Greenberger N. J., Rodgers J. B., Isselbacher K. J. Absorption of medium and long chain triglycerides: factors influencing their hydrolysis and transport. J Clin Invest. 1966 Feb;45(2):217–227. doi: 10.1172/JCI105334. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. McHugh P. R., Moran T. H. Calories and gastric emptying: a regulatory capacity with implications for feeding. Am J Physiol. 1979 May;236(5):R254–R260. doi: 10.1152/ajpregu.1979.236.5.R254. [DOI] [PubMed] [Google Scholar]
  13. Read N. W., McFarlane A., Kinsman R. I., Bates T. E., Blackhall N. W., Farrar G. B., Hall J. C., Moss G., Morris A. P., O'Neill B. Effect of infusion of nutrient solutions into the ileum on gastrointestinal transit and plasma levels of neurotensin and enteroglucagon. Gastroenterology. 1984 Feb;86(2):274–280. [PubMed] [Google Scholar]
  14. Schemann M., Ehrlein H. J. Postprandial patterns of canine jejunal motility and transit of luminal content. Gastroenterology. 1986 Apr;90(4):991–1000. doi: 10.1016/0016-5085(86)90878-4. [DOI] [PubMed] [Google Scholar]
  15. Sladen G. E., Dawson A. M. Interrelationships between the absorptions of glucose, sodium and water by the normal human jejunum. Clin Sci. 1969 Feb;36(1):119–132. [PubMed] [Google Scholar]
  16. Spiller R. C., Brown M. L., Phillips S. F. Decreased fluid tolerance, accelerated transit, and abnormal motility of the human colon induced by oleic acid. Gastroenterology. 1986 Jul;91(1):100–107. doi: 10.1016/0016-5085(86)90445-2. [DOI] [PubMed] [Google Scholar]
  17. Spiller R. C., Lee Y. C., Edge C., Ralphs D. N., Stewart J. S., Bloom S. R., Silk D. B. Delayed mouth-caecum transit of a lactulose labelled liquid test meal in patients with steatorrhoea caused by partially treated coeliac disease. Gut. 1987 Oct;28(10):1275–1282. doi: 10.1136/gut.28.10.1275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Spiller R. C., Trotman I. F., Higgins B. E., Ghatei M. A., Grimble G. K., Lee Y. C., Bloom S. R., Misiewicz J. J., Silk D. B. The ileal brake--inhibition of jejunal motility after ileal fat perfusion in man. Gut. 1984 Apr;25(4):365–374. doi: 10.1136/gut.25.4.365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Tatemoto K., Mutt V. Isolation of two novel candidate hormones using a chemical method for finding naturally occurring polypeptides. Nature. 1980 Jun 5;285(5764):417–418. doi: 10.1038/285417a0. [DOI] [PubMed] [Google Scholar]
  20. Thor K., Rosell S., Rökaeus A., Kager L. (Gln4)-neurotensin changes the motility pattern of the duodenum and proximal jejunum from a fasting-type to a fed-type. Gastroenterology. 1982 Sep;83(3):569–574. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES