Skip to main content
Log in

A study of motility of normal human gastroduodenal region

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

A method of recording continuously and simultaneously the intraluminal pressure in the antrum, pylorus, and duodenal bulb has been used to study gastroduodenal motility during intragastric infusion of saline. Twenty-two studies were performed in 15 normal individuals. Two types of contraction were recorded: (1) independent contractions of the individual parts of the gastroduodenal region, and (2) related contractions of the antrum, pylorus, and duodenal bulb, resulting in a concerted contraction of the whole region. The majority of pyloric contractions were part of a concerted contraction of the whole gastroduodenal region during which the pylorus behaved as the terminal part of the antrum. The majority of duodenal contractions were not associated with pyloric contractions, only 21.7% of duodenal contractions coincided with closure of the pylorus. This suggests that under the conditions of this study the pylorus was not acting as a barrier to reflux. An elevated basal pressure was never recorded from within the pylorus; apart from a brief closure during contraction, the pylorus is always open.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fisher, RS, Cohen S: Pyloric sphincter dysfunction in patients with gastric ulcer. N Engl J Med 288:273–276, 1973

    PubMed  Google Scholar 

  2. Johnson, HD: The pylorus: Its function and some surgical considerations. Proc R Soc Med 54:938–940, 1961

    PubMed  Google Scholar 

  3. Quigley JP, Louckes HS: Gastric emptying. Am J Dig Dis 7:672–676, 1962

    PubMed  Google Scholar 

  4. Thomas JE: Mechanics and regulation of gastric emptying. Physiol Rev 37:453–1957

  5. Du Plessis DJ: Pathogenesis of gastric ucleration. Lancet 1:974–978, 1965

    Google Scholar 

  6. Capper WM, Airth GR, Kilby JO: A test for pyloric regurgitation. Lancet 2:621–623, 1966

    PubMed  Google Scholar 

  7. Rhodes J, Barnardo DE, Phillips SF, Rovelstad RA, Hofmann AF: Increased reflux of bile into the stomach in patients with gastric ulcer. Gastroenterology 57:241–252, 1969

    PubMed  Google Scholar 

  8. Delaney JP, Cheng JWB, Butler BA, Ritchie WPJ: Gastric ulcer and regurgitation gastritis. Gut 11:715–719 1970

    PubMed  Google Scholar 

  9. Johnson AG: Pyloric function and gallstone dyspepsia. Br J Surg 59:449–454, 1972

    PubMed  Google Scholar 

  10. Gillison EW, Nyhus LM, Duthie HL: Bile reflux, gastric secretion and heartburn. Br J Surg 58:864, 1971

    Google Scholar 

  11. Stol DW, Murphy G, Collis JL: Duodenogastric reflux and acid secretion in patients with symptomatic hiatal hernia. Scand J Gastroenterol 9:97–101, 1974

    PubMed  Google Scholar 

  12. Toye DKM, Williams JA: Postgastrectomy bile vomiting. Lancet 2:524–526, 1965

    PubMed  Google Scholar 

  13. Fisher RS, Cohen S: The physiologic characteristics of the human pyloric sphincter. Gastroenterology 64:67–75, 1973

    PubMed  Google Scholar 

  14. Gibbs WT: A theory concerning the manner in which the stomach empties itself. Ann Intern Med 16:94–103, 1942

    Google Scholar 

  15. Atkinson M, Edwards DAW, Honour AJ, Rowlands EN: Comparison of cardiac and pyloric sphincters, a manometric study. Lancet 2:918–922, 1957

    Google Scholar 

  16. Edwards DAW: Physiological concepts of the pylorus. Proc R Soc Med 54:930–933, 1961

    PubMed  Google Scholar 

  17. Andersson S, Grossman MI: Profile of pH, pressure and potential difference at the gastroduodenal junction in man. Gastroenterology 49:364–371, 1965

    PubMed  Google Scholar 

  18. Kaye MD, Mehta SJ, Showalter JP: Manometric studies of the human pylorus. Gastroenterology 70:477–480, 1976

    PubMed  Google Scholar 

  19. Code CF, Marlett JA: The interdigestive myoelectric complex of the stomach and small bowel of dogs. J Physiol (London) 246:289–309, 1975

    Google Scholar 

  20. Hunt JN, Knox MT: Regulation of gastric emptying.In Handbook of Physiology, Section 6: Alimentary Canal, Vol 4, CF Code (ed). American Physiological Society. Washington DC, 1968, pp 1917–1925

    Google Scholar 

  21. Hightower NC Jr, Code CF: The quantitative analysis of antral gastric motility records in normal human beings, with a study of the effects of neostigmine. Proc Mayo Clin 25:679–705, 1950

    Google Scholar 

  22. Carlson HC, Code CF, Nelson RA: Motor action of the canine gastro-duodenal junction: A cineradiographic, pressure and electric study. Am J Dig Dis 11:155–172, 1966

    PubMed  Google Scholar 

  23. Reinke DA, Rosenbaum AM, Bennett DR: Patterns of dog gastrointestinal contractile activity monitoredin vivo with extraluminal force transducers. Am J Dig Dis 12:113–141, 1967

    PubMed  Google Scholar 

  24. Friedman G, Wolf BS, Waye JD, Janowitz HD: Correlation of cineradiographic and intraluminal pressure changes in the human duodenum: an analysis of the functional significance of monophasic waves. Gastroenterology 49:37–49, 1965

    Google Scholar 

  25. Smith AWM, Code CF, Schlegel JF: Simultaneous cineradiographic and kymographic studies of human gastric motility. J Appl Physiol 11:12–16, 1957

    PubMed  Google Scholar 

  26. Brody DA, Werle JM, Meschan I, Quigley JP: Intralumen pressures in the digestive tract, especially in the pyloric region. Am J Physiol 130:791–801, 1940

    Google Scholar 

  27. Gershon-Cohen J, Shay H: Experimental studies on gastric physiology in man III. A study of pyloric control. The role of milk and cream in the normal and in subjects with quiescent duodenal ulcer. Roentgenology 38:427–446, 1937

    Google Scholar 

  28. Werle JM, Brody DA, Ligon EW, Read MR, Quigley JP: The mechanics of gastric evacuation. Am J Physiol 191(3):606–614, 1941

    Google Scholar 

  29. Stemper TJ, Cooke AR: Gastric emptying and its relationship to antral contractile activity. Gastroenterology 69:649–653, 1975

    PubMed  Google Scholar 

  30. Rees WDW, Malagelada JR, Go VLW: Human interdigestive motor activity: Effect of saline and liquid nutrient meals. Gastroenterology 74:1083, 1978

    Google Scholar 

  31. Weisbrodt NW, Wiley JN, Overholt BF, Bass P: A relation between gastroduodenal muscle contractions and gastric emptying. Gut 10:543–548, 1969

    PubMed  Google Scholar 

  32. Cole LG: Motor phenomena of the stomach, pylorus and cap observed roentgenographically. Am J Physiol 42:618–619, 1917

    Google Scholar 

  33. Golden R: Antral gastritis and spasm. Am Med Ass 109:1479–1500, 1937

    Google Scholar 

  34. Keet AD: The prepyloric contractions in the normal stomach. Acta Radiol 48:413–424, 1957

    PubMed  Google Scholar 

  35. Keet AD: Diameter of the pyloric aperture. Acta Radiol 57:31–44, 1962

    PubMed  Google Scholar 

  36. Rees WDW, Go VLW, Malagelada J-R: Simultaneous measurement of antroduodenal motility, gastric emptying, and duodenogastric reflux in man. Gut 20:963–970, 1979

    PubMed  Google Scholar 

  37. Penick SB, Smith GP, Wieneke K, Hinkel LE: An experimental evaluation of the relationship between hunger and gastric motility. Am J Physiol 205:421–426, 1963

    PubMed  Google Scholar 

  38. Nelsen TS, Kohatsu S: Clinical electrogastrography and its relationship to gastric surgery Am J Surg 116:215–222, 1968

    PubMed  Google Scholar 

  39. Kwong NK, Brown BH, Whittaker GE, Duthie HL: Electrical activity of the gastric antrum in man. Br J Surg 57:913–916, 1970

    PubMed  Google Scholar 

  40. Duthie HL, Kwong NK, Brown BH, Whittaker GE: Pacesetter potential of the human gastroduodenal junction. Gut 12:250–256, 1971

    PubMed  Google Scholar 

  41. Christiansen J, Schedl HP, Clifton JA: The basic electrical rhythm of the duodenum in normal human subjects and in patients with thyroid disease. J Clin Invest 43:1659–1667, 1964

    PubMed  Google Scholar 

  42. Duthie HL, Brown BH, Robertson-Dunn B, Kwong NK, Whittaker GE, Waterfall W: Electrical activity in the gastroduodenal area—slow waves in the proximal duodenum, a comparison of man and dog. Am J Dig Dis 17:334–351, 1972

    Google Scholar 

  43. Bortoff A, Davis RS: Myogenic transmission of antral slow waves across the gastroduodenal junctionin situ. Am J Physiol 215:889–897, 1968

    PubMed  Google Scholar 

  44. Bass P, Code CF, Lambert EM: Electric activity of gastroduodenal junction. Am J Physiol 201:587–592, 1961

    PubMed  Google Scholar 

  45. Bortoff A, Weg N: Transmission of electrical activity through the gastroduodenal junction. Am J Physiol 208:531–536, 1965

    PubMed  Google Scholar 

  46. Payne WW, Poulton EP: Visceral pain in the upper alimentary tract. Q J Med 17:53–80, 1923

    Google Scholar 

  47. Ivy AC, Vloedman DA, Keane J: The small intestine in hunger. Am J Physiol 72:99–108, 1925

    Google Scholar 

  48. Berger T: Studies on the gastric emptying mechanism in healthy persons and patients after partial gastrectomy. Acta Chir Scand (Suppl) 404:1, 1969

    Google Scholar 

  49. Allen GL, Poole EW, Code CF: Relationships between electrical activities of antrum and duodenum. Am J Physiol 207:906–910, 1964

    PubMed  Google Scholar 

  50. Kelly M, Kennedy T: Motility changes in the antrum after proximal gastric vagotomy. Br J Surg 62:215–220, 1975

    PubMed  Google Scholar 

  51. Thomas JE, Crider JO: Rhythmic changes in duodenal motility associated with gastric peristalsis. Am J Physiol 11:124–129, 1935

    Google Scholar 

  52. Thomas JE: Mechanics and regulation of gastric emptying. Physiol Rev 37:453–474, 1957

    PubMed  Google Scholar 

  53. Quigley JP, Werle JM, Brody DA: The correlation of antral and bulbar pressures with flouroscopic observations during gastric evacuation. Am J Dig Dis 7:434–435, 1940

    Google Scholar 

  54. Capper WM: Factors in the pathogenesis of gastric ulcer. Ann R Coll Surg Engl 40:21–34, 1967

    PubMed  Google Scholar 

  55. Alvarez WC, Mahoney LJ: The relations between gastric and duodenal peristalsis. Am J Physiol 64:371–386, 1923

    Google Scholar 

  56. Szurszewski JH: A migrating electric complex of the canine small intestine. Am J Physiol 217:1757–1763, 1969

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

White, C.M., Poxon, V. & Alexander-Williams, J. A study of motility of normal human gastroduodenal region. Digest Dis Sci 26, 609–617 (1981). https://doi.org/10.1007/BF01367673

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01367673

Keywords

Navigation