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. 1992 Apr;33(4):466–471. doi: 10.1136/gut.33.4.466

Relation of pyloric motility to pyloric opening and closure in healthy subjects.

G Tougas 1, M Anvari 1, J Dent 1, S Somers 1, D Richards 1, G W Stevenson 1
PMCID: PMC1374060  PMID: 1582588

Abstract

The relation between pyloric motor activity, opening, and closure was examined in eight healthy men. Manometry was performed with an assembly combining 13 side holes and a sleeve sensor positioned astride the pylorus. Simultaneous with manometry, pyloric opening and closure and antroduodenal contractions were observed fluoroscopically with the antrum filled with barium. During intraduodenal normal saline infusion, coordinated antral pressure waves swept over the pylorus and ejected barium into the duodenum. No localised pyloric motor pattern was observed under these conditions. In contrast, the intraduodenal triglyceride infusion was associated with the absence of antral pressure waves and virtual absence of antral wall movement. At the pylorus, there was a zone of luminal occlusion less than 1 cm long that persisted for the period of observation. This zone of luminal occlusion corresponded precisely with manometric recordings of a narrow zone of pyloric phasic and tonic activity. During the duodenal triglyceride infusion, the pylorus was closed for 98.5% of the measurement period when basal pyloric pressure was 4 mm Hg or more, and during this motor pattern, barium did not traverse the pylorus. Localised pyloric contractions cause sustained pyloric closure, whether these contractions are phasic or tonic. These contractions occur independently of antral or duodenal contractions and may interrupt gastric emptying.

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Selected References

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

  1. Carlson H. C., Code C. F., Nelson R. A. Motor action of the canine gastroduodenal junction: a cineradiographic, pressure, and electric study. Am J Dig Dis. 1966 Feb;11(2):155–172. doi: 10.1007/BF02239239. [DOI] [PubMed] [Google Scholar]
  2. Dent J. A new technique for continuous sphincter pressure measurement. Gastroenterology. 1976 Aug;71(2):263–267. [PubMed] [Google Scholar]
  3. Dooley C. P., Reznick J. B., Valenzuela J. E. Variations in gastric and duodenal motility during gastric emptying of liquid meals in humans. Gastroenterology. 1984 Nov;87(5):1114–1119. [PubMed] [Google Scholar]
  4. Ehrlein H. J. Motility of the pyloric sphincter studied by the inductograph method in conscious dogs. Am J Physiol. 1988 May;254(5 Pt 1):G650–G657. doi: 10.1152/ajpgi.1988.254.5.G650. [DOI] [PubMed] [Google Scholar]
  5. Fisher R., Cohen S. Physiological characteristics of the human pyloric sphincter. Gastroenterology. 1973 Jan;64(1):67–75. [PubMed] [Google Scholar]
  6. Heddle R., Dent J., Read N. W., Houghton L. A., Toouli J., Horowitz M., Maddern G. J., Downton J. Antropyloroduodenal motor responses to intraduodenal lipid infusion in healthy volunteers. Am J Physiol. 1988 May;254(5 Pt 1):G671–G679. doi: 10.1152/ajpgi.1988.254.5.G671. [DOI] [PubMed] [Google Scholar]
  7. Heddle R., Dent J., Toouli J., Read N. W. Topography and measurement of pyloric pressure waves and tone in humans. Am J Physiol. 1988 Oct;255(4 Pt 1):G490–G497. doi: 10.1152/ajpgi.1988.255.4.G490. [DOI] [PubMed] [Google Scholar]
  8. Hinder R. A., Bremner C. G. Relative role of pyloroplasty size, truncal vagotomy, and milk meal volume in canine gastric emptying. Am J Dig Dis. 1978 Mar;23(3):210–216. doi: 10.1007/BF01072319. [DOI] [PubMed] [Google Scholar]
  9. Houghton L. A., Read N. W., Heddle R., Horowitz M., Collins P. J., Chatterton B., Dent J. Relationship of the motor activity of the antrum, pylorus, and duodenum to gastric emptying of a solid-liquid mixed meal. Gastroenterology. 1988 Jun;94(6):1285–1291. doi: 10.1016/0016-5085(88)90665-8. [DOI] [PubMed] [Google Scholar]
  10. Kaye M. D., Mehta S. J., Showalter J. P. Manometric studies of the human pylorus. Gastroenterology. 1976 Apr;70(4):477–480. [PubMed] [Google Scholar]
  11. Keinke O., Ehrlein H. J. Effect of oleic acid on canine gastroduodenal motility, pyloric diameter and gastric emptying. Q J Exp Physiol. 1983 Oct;68(4):675–686. doi: 10.1113/expphysiol.1983.sp002757. [DOI] [PubMed] [Google Scholar]
  12. McShane A. J., O'Morain C., Lennon J. R., Coakley J. B., Alton B. G. Atraumatic non-distorting pyloric sphincter pressure studies. Gut. 1980 Oct;21(10):826–828. doi: 10.1136/gut.21.10.826. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Müller-Lissner S. A., Blum A. L. To-and-fro movements across the canine pylorus. Scand J Gastroenterol Suppl. 1984;92:1–3. [PubMed] [Google Scholar]
  14. SMITH A. W., CODE C. F., SCHLEGEL J. F. Simultaneous cineradiographic and kymographic studies of human gastric antral motility. J Appl Physiol. 1957 Jul;11(1):12–16. doi: 10.1152/jappl.1957.11.1.12. [DOI] [PubMed] [Google Scholar]
  15. Shafer R. B., Levine A. S., Marlette J. M., Morley J. E. Do calories, osmolality, or calcium determine gastric emptying? Am J Physiol. 1985 Apr;248(4 Pt 2):R479–R483. doi: 10.1152/ajpregu.1985.248.4.R479. [DOI] [PubMed] [Google Scholar]
  16. Valenzuela J. E., Defilippi C. Pyloric-sphincter studies in peptic-ulcer patients: pylorus in peptic ulcer. Am J Dig Dis. 1976 Mar;21(3):229–232. doi: 10.1007/BF01095895. [DOI] [PubMed] [Google Scholar]
  17. Weisbrodt N. W., Wiley J. N., Overholt B. F., Bass P. A relation between gastroduodenal muscle contractions and gastric empyting. Gut. 1969 Jul;10(7):543–548. doi: 10.1136/gut.10.7.543. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. White C. M., Poxon V., Alexander-Williams J. A study of motility of normal human gastroduodenal region. Dig Dis Sci. 1981 Jul;26(7):609–617. doi: 10.1007/BF01367673. [DOI] [PubMed] [Google Scholar]
  19. White C. M., Poxon V., Alexander-Williams J. Effects of nutrient liquids on human gastroduodenal motor activity. Gut. 1983 Dec;24(12):1109–1116. doi: 10.1136/gut.24.12.1109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. White C. M., Poxon V., Alexander-Williams J. The importance of the distal stomach in gastric emptying of liquids in man. Surg Gastroenterol. 1984;3(1):13–20. [PubMed] [Google Scholar]

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