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  • 1
    ISSN: 1573-2568
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Although abdominal complaints are frequent in both acute and chronic alcoholism, little is known of the effect of ingestion of ethanol with a meal on the function of the upper digestive tract. We have studied the effects of oral ethanol (1 g/kg body wt) taken with food on (1) the gastric emptying rate of a solid-liquid meal as measured by a dual radioisotope technique in six normal subjects; and (2) the gastric response (emptying and secretion), biliopancreatic secretions, and duodenal nutrient absorption after an homogenized meal, as evaluated by a gastroduodenal intubation-marker perfusion technique on seven healthy volunteers. In the latter experiments, radioimmunoassays of gastrin, secretin, cholecystokinin, pancreatic polypeptide, motilin, somatostatin, gastric inhibitory polypeptide, and vasoactive intestinal polypeptide were performed serially. As compared with the control experiment, alcohol induced the following effects: (1) marked delay of gastric emptying of solids, smaller slowing effect on gastric emptying of the liquid phase of the solid-liquid meal and of the homogenized meal; (2) no significant change in gastric acid secretion; (3) no change in the overall postprandial pancreatic enzyme outputs, but a delay of lipase secretion; (4) no change in the early bile salt postprandial output, but a reduced bile salt secretion from the second postprandial hour onwards; (5) no significant change in carbohydrate and lipid duodenal absorption; and (6) a significantly greater postcibal gastrin release. The mechanisms for these effects of alcohol on upper digestive tract function remain to be clarified.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1573-2568
    Schlagwort(e): gastric emptying ; radioisotopes ; gastroparesis ; dyspepsia ; gastrokinetics ; cisapride
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Twenty-eight patients with chronic idiopathic dyspepsia defined by the presence of chronic unexplained symptoms suggestive of gastric stasis and directly related to food ingestion were included in this prospective study. Gastric emptying of the liquid and solid phases of a meal was quantified by a dual-isotope method, and symptoms were evaluated by a diary and a visual analog scale. Delay in gastric emptying was evidenced in 59% of the dyspeptic patients; it occurred with liquids in more cases than solids. Quantitative and qualitative evaluation of symptoms was of no practical value in predicting the presence of objective stasis. The dyspeptic patients were included in a double- blind randomized controlled trial of cisapride, a new gastrokinetic drug devoid of central antiemetic effects. After six weeks of cisapride treatment, all patients with initially abnormal gastric emptying rates for liquids, and all but one for solids returned to normal ranges, and significant differences between cisapride and placebo groups were observed for half emptying times of both solids (136±16 min vs 227 ±32 min; P〈0.02) and liquids (61±4 min vs 132±37 min; P〈0.01). Cisapride also significantly improved dyspeptic symptom scores at weeks 3 and 6 of treatment as compared to those measured before treatment. Nevertheless, the decrease in global diary score was significantly higher than that seen with placebo at week 3 (−16±6 vs −1±9; P〈0.05), but not at week 6 (−18±5 vs −10±8). The symptomatic effect of cisapride at week 3 was significantly more pronounced in patients with abnormal initial gastric emptying than in those with normal gastric emptying (−30±7vs −4±6; P〈0.02).These results underline the importance of objective evaluation of gastric emptying in the detection of patients with gastric stasis who exhibited the best symptomatic response to cisapride.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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