Small Bowel Motility Affects Glucose Absorption in a Healthy Man
- Matthijs P. Schwartz, MD, PHD,
- Melvin Samsom, MD, PHD,
- Willem Renooij, PHD,
- Leo W. van Steenderen,
- Marc A. Benninga, MD, PHD,
- Erwin-Jan M. van Geenen,
- Margot A. van Herwaarden, MD, PHD,
- Martin B.M. de Smet and
- André J.P.M. Smout, MD, PHD
- From the Gastrointestinal Research Unit, Departments of Gastroenterology and Surgery, University Medical Center, Utrecht, The Netherlands
Abstract
OBJECTIVE—To investigate the relationship between duodenojejunal motor activity and glucose absorption and to evaluate the effect of modification of duodenojejunal motility on glucose absorption by using the prokinetic drug cisapride.
RESEARCH DESIGN AND METHODS—We examined seven healthy males, mean age 22 years, who were treated with cisapride 10 mg t.i.d. and placebo during 3 days in a randomized order, with a 2-week time interval. Duodenojejunal manometry was performed after each treatment on the morning of day 3, using an 18-lumen catheter. A liquid nutrient (3 kcal/min) was administered intraduodenally for 30 min, followed by a bolus of the glucose analog 3-O-methylglucose (3-OMG). Plasma 3-OMG concentrations were measured to assess absorption kinetics.
RESULTS—The area under the 3-OMG concentration curve in the first 30 min after infusion was related to the number of antegrade propagated pressure waves (r = 0.49, P < 0.05), but not to the peak concentration, time to peak, and absorption fraction. The mean amplitude of pressure waves was higher during cisapride than placebo (P < 0.05), but the reoccurrence of interdigestive motility, numbers of pressure waves, and propagated pressure waves, as well as 3-OMG absorption characteristics, were not significantly different between the two treatments. During both treatments >60% of antegrade propagated pressure waves were propagated over a very short distance (1.5 cm).
CONCLUSIONS—Glucose absorption in the human small intestine is related to short-traveling propagated intestinal contractile activity. Cisapride increases the amplitude of pressure waves, but does not affect the organization of pressure waves or the absorption of 3-OMG.
- 3-OMG, 3-O-methylglucose
- APPW, antegrade propagated pressure wave
- AUC, area under the curve
- TMPD, transmucosal potential difference
Footnotes
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Address correspondence and reprint requests to M.P. Schwartz, Department of Gastroenterology, University Medical Center, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. E-mail: m.p.schwartz{at}azu.nl.
Received for publication 17 January 2002 and accepted in revised form 11 July 2002.
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