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. 1989 Jun;30(6):815–819. doi: 10.1136/gut.30.6.815

Jejunal motility during cyclic total parenteral nutrition in patients with Crohn's disease.

P Ducrotte 1, E Koning 1, F Guillemot 1, C Guedon 1, E Lerebours 1, P Denis 1, R Colin 1
PMCID: PMC1434152  PMID: 2502485

Abstract

Our aim was to study the jejunal motility (a) in seven patients receiving longterm (median: 24 days) cyclic total parenteral nutrition (CTPN) for an acute exacerbation of Crohn's disease involving the ileum and/or the colon without any sign of occlusion and (b) in six healthy volunteers undergoing the same parenteral nutrition for one day after an overnight fast. Continuous recordings, lasting 20 hours, were carried out in patients after correction of their nutritional status and significant improvement of the Crohn's disease activity index. In five of the seven patients, we recorded seven to 14 phase III episodes (PIII) (median: 10), both more frequent and slower during the nocturnal part of the recording time as compared with diurnal. Seven to 18 PIIIs (median: 12) were found in controls. The overall duration of the motor activity was not different between these five patients and controls. In the remaining two patients, no PIII episode was recorded and 79% and 57% respectively of the whole recording time consisted of irregular motor activity. Our work therefore, shows that: (a) PIIIs remain and have a circadian variation in their periodicity and propagation velocity, in most of our patients undergoing longterm CTPN (b) CTPN does not determine a longer duration of motor rest of the small bowel in patients than in controls submitted for a short period of time to the same parenteral intake.

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Selected References

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

  1. Dickinson R. J., Ashton M. G., Axon A. T., Smith R. C., Yeung C. K., Hill G. L. Controlled trial of intravenous hyperalimentation and total bowel rest as an adjunct to the routine therapy of acute colitis. Gastroenterology. 1980 Dec;79(6):1199–1204. [PubMed] [Google Scholar]
  2. Driscoll R. H., Jr, Rosenberg I. H. Total parenteral nutrition in inflammatory bowel disease. Med Clin North Am. 1978 Jan;62(1):185–201. doi: 10.1016/s0025-7125(16)31831-4. [DOI] [PubMed] [Google Scholar]
  3. Guedon C., Ducrotte P., Chayvialle J. A., Lerebours E., Denis P., Colin R. Effects of intravenous and intraduodenal fat on jejunal motility and on plasma cholecystokinin in man. Dig Dis Sci. 1988 May;33(5):558–564. doi: 10.1007/BF01798357. [DOI] [PubMed] [Google Scholar]
  4. Kerlin P., Phillips S. Variability of motility of the ileum and jejunum in healthy humans. Gastroenterology. 1982 Apr;82(4):694–700. [PubMed] [Google Scholar]
  5. Kumar D., Wingate D., Ruckebusch Y. Circadian variation in the propagation velocity of the migrating motor complex. Gastroenterology. 1986 Oct;91(4):926–930. doi: 10.1016/0016-5085(86)90696-7. [DOI] [PubMed] [Google Scholar]
  6. Labò G., Bortolotti M., Vezzadini P., Bonora G., Bersani G. Interdigestive gastroduodenal motility and serum motilin levels in patients with idiopathic delay in gastric emptying. Gastroenterology. 1986 Jan;90(1):20–26. doi: 10.1016/0016-5085(86)90069-7. [DOI] [PubMed] [Google Scholar]
  7. Lerebours E., Messing B., Chevalier B., Bories C., Colin R., Bernier J. J. An evaluation of total parenteral nutrition in the management of steroid-dependent and steroid-resistant patients with Crohn's disease. JPEN J Parenter Enteral Nutr. 1986 May-Jun;10(3):274–278. doi: 10.1177/0148607186010003274. [DOI] [PubMed] [Google Scholar]
  8. Matuchansky C., Morichau-Beauchant M., Druart F., Tapin J. Cyclic (nocturnal) total parenteral nutrition in hospitalized adult patients with severe digestive diseases. Report of a prospective study. Gastroenterology. 1981 Sep;81(3):433–437. [PubMed] [Google Scholar]
  9. Powell-Tuck J., Nielsen T., Farwell J. A., Lennard-Jones J. E. Team approach to long-term intravenous feeding in patients with gastrointestinal disorders. Lancet. 1978 Oct 14;2(8094):825–828. doi: 10.1016/s0140-6736(78)92601-6. [DOI] [PubMed] [Google Scholar]
  10. Summers R. W., Anuras S., Green J. Jejunal manometry patterns in health, partial intestinal obstruction, and pseudoobstruction. Gastroenterology. 1983 Dec;85(6):1290–1300. [PubMed] [Google Scholar]
  11. Vantrappen G., Janssens J., Hellemans J., Ghoos Y. The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. J Clin Invest. 1977 Jun;59(6):1158–1166. doi: 10.1172/JCI108740. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Weisbrodt N. W., Copeland E. M., Thor P. J., Dudrick S. J. The myoelectric activity of the small intestine of the dog during total parenteral nutrition. Proc Soc Exp Biol Med. 1976 Oct;153(1):121–124. doi: 10.3181/00379727-153-39493. [DOI] [PubMed] [Google Scholar]

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