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. 1999 Oct;45(4):575–580. doi: 10.1136/gut.45.4.575

Local regulation of postprandial motor responses in ileal pouches

A Mularczyk 1, E Contessini-Avesan 1, B Cesana 1, P Bianchi 1, G Basilisco 1
PMCID: PMC1727696  PMID: 10486368

Abstract

BACKGROUND—Local mechanisms are involved in the postprandial regulation of ileal tone in healthy subjects, but whether these mechanisms affect the postprandial tonic response of ileal pouches has not yet been investigated.
AIMS—To study the effect of a meal on pouch tone and phasic motor activity in patients with gut continuity or ileostomy and, in the latter group, the effect of a pouch perfusion with chyme or saline.
PATIENTS—Twenty patients with ileal pouches: 10 with gut continuity and 10 with ileostomy.
METHODS—Pouch tone and the frequency of phasic volume events were recorded with a barostat under fasting and postprandial conditions and after perfusion of the isolated pouch with chyme or saline.
RESULTS—The meal increased pouch tone and the frequency of phasic volume events in the patients with gut continuity, but not in those with ileostomy. Pouch perfusion with chyme induced a greater increase in pouch tone than saline.
CONCLUSIONS—The meal stimulated pouch tone and phasic motor activity. These effects were at least partially related to local pouch stimulation by intraluminal contents.


Keywords: ileal pouches; postprandial motor responses; ileal tone; ileostomy; motor activity; barostat

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Figure 1  .

Figure 1  

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Representative tracings showing the effect of a meal on pouch tone and the number of phasic volume events in one patient with gut continuity and one with ileostomy. The distending pressure was 7 mm Hg throughout the experiments in both cases. Note the progressive decrease in pouch volume and the increased frequency of rapid volume changes after the meal only in the pouch in continuity with the gut.

Figure 2  .

Figure 2  

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Effect of a meal on pouch tone in patients with gut continuity or ileostomy. Under fasting conditions, pouch volumes were significantly greater in the patients with gut continuity than in those with ileostomy (p = 0.0001). The meal induced a significant decrease in pouch volume in the patients with gut continuity (p = 0.0014), but not in those with ileostomy. The distending pressure was constant throughout the experiments. Results are mean (SD).

Figure 3  .

Figure 3  

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Effect of a meal on the number of phasic volume events in patients with gut continuity or ileostomy. The mean (SD) of phasic volume events in the hour preceding and following the meal are shown for the two groups of patients. The number of phasic volume events after the meal significantly increased only in the patients with gut continuity.

Figure 4  .

Figure 4  

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Pouch distensibility during volume-controlled (A) and pressure-controlled (B) distensions in patients with gut continuity or ileostomy. The patients with gut continuity tolerated the distensions up to the maximum tested volume of 300 ml and pressure of 35 mm Hg, whereas those with ileostomy interrupted the distensions from volumes >90 ml and pressures >11 mm Hg. The pressure/volume ratio during volume-controlled distension was significantly lower in the patients with gut continuity than in those with ileostomy (p = 0.0001), and the slope of the volume/pressure relation during pressure-controlled distension was significantly steeper in the former than in the latter (p = 0.0001). Data are mean (SD) of pressures (A) or volumes (B) during distension.

Figure 5  .

Figure 5  

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Effect of perfusions with chyme and saline on pouch tone in the patients with isolated pouches. The difference between baseline and the first five minute period after infusion with chyme was significant (p = 0.0044). The distending pressure was constant throughout the experiments. Data are mean (SD).

Selected References

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

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