Digestive Diseases and Sciences

, Volume 47, Issue 11, pp 2473–2479 | Cite as

Inhibitory Reflexive Effect of Rectal Distension on Postprandial Gastric Myoelectrical Activity

  • Liwei Qian
  • William C. Orr
  • J.D.Z. Chen
Article

Abstract

The aim of the study was to determine the effects of low-volume rectal distension on gastric myoelectrical activity. The study was performed in 14 healthy volunteers in 2 randomized sessions. In the control session, a small balloon was inserted into the rectum 10 cm beyond the anal verge and inflated with 20 ml of air. Gastric myoelectrical activity was recorded for 30 minutes in the fasting state and 30 minutes after a meal; and then the balloon was deflated and removed, and another 30-min recording was followed. The study session was the same except that after the 30-min baseline recording the balloon was inflated to reach a volume with which the subject felt an urgency for defecation. Spectral analyses were performed to compute the dominant frequency, power, and regularity (2–4 cycles/minutes, cpm) of the gastric slow waves and the percentage of gastric dysrhythmia. Results: 1). In comparison with our previously published data, the placement of the rectal balloon with a volume of 20 ml air did not affect the regularity of the slow waves (84.2 ± 3.6% in fasting, 85.3 ± 4.3% in fed); In comparison with the control session, the rectal distension inducing an urgency for defecation (average volume of air: 72.5 ml) significantly reduced the regularity of gastric slow waves in the fed state (72.0 ± 5.7%, P < 0.03 vs baseline; P < 0.02, vs control session) but not in the fasting state (80.1 ± 4.5%, P = 0.1). This postprandial change was attributed to a significant increase in bradygastria (3.1 ± 1.0% vs 7.9 ± 2.6%, P < 0.04) and a marginal increase in tachygastria (7.4 ± 2.5% vs 15.8 ± 4.3%, P = 0.06). The normal postprandial increases in the dominant frequency and power of the gastric slow wave were abolished in both sessions. conclusions, rectal distension evoking an urgency for defecation impairs postprandial gastric slow waves with an increase in the percentage of both bradygastria and tachygastria.

rectogastric reflex anorectal distension gastric myoelectrical activity gastric dysrhythmia electrogastrography 

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REFERENCES

  1. 1.
    Evans PR, Bak YT, Shuter B, Hoschl R, Kellow JE: Gastroparesis and small bowel dysmotility in irritable bowel syndrome. Dig Dis Sci. 42(10):2087–2093, 1997Google Scholar
  2. 2.
    Caballero-Plasencia AM, Valenzuela-Barranco M, Herrerias-Gutierrez JM, Esteban-Carretero JM. Altered gastric emptying in patients with irritable bowel syndrome. Eur J Nucl Med. 26(4):404–409, 1999Google Scholar
  3. 3.
    Youmans WM, Meak WJ: Reflex and humoral gastrointestinal inhibition in unanesthetized dogs during rectal stimulation. Am J Physiol 120:750–755, 1937Google Scholar
  4. 4.
    Azpiroz F, Malagelada J-R: Perception and reflex relaxation of the stomach in response to gut distention. Gastroenterology 98:1193–1198, 1990Google Scholar
  5. 5.
    Bojo L, Cassuto J: Gastric reflex relaxation by colonic distention. Journal-of Autonomic nervous Syst 38:57–64, 1992Google Scholar
  6. 6.
    Julia V, Su X, Bueno L, Gebhart GF: Role of neurokinin 3 receptors on responses to colorectal distention in the rats: electrophysiological and behavioral studies. Gastroenterology. 116(5):1124–1131, 1999Google Scholar
  7. 7.
    Jansson G; Vagovagal reflex relaxation of the stomach in the cat. Acta Physiol Scand 75:245–252, 1969Google Scholar
  8. 8.
    Glise G, Abrahamsson H: Reflex vagal inhibition of gastric motility by intestinal nociceptive stimulation in the cat. Scand J Gastroenterol 15:769–744, 1980Google Scholar
  9. 9.
    Youle MS, Read NW: Effect of painless rectal distention on gastrointestinal transit of solid meal. Dig Dis Sci 29(10):902–906, 1984Google Scholar
  10. 10.
    Kellow JE, Gill RC, Wingate DL: Modulation of human upper gastrointestinal motility by rectal distention. Gut 28:864–868, 1987Google Scholar
  11. 11.
    Iovina P, Azpiroz F, Domingo E, Malagelada J-R: The sympathetic nervous system modulates perception and reflex responses to gut distention in humans. Gastroenterology 108:680–686, 1995Google Scholar
  12. 12.
    Orr WC, Crowell MD, Lin B, Harnish MJ, Chen JD: Sleep and gastric function in irritable bowel syndrome: derailing the brain-gut axis. Gut 41(3):390–393, 1997Google Scholar
  13. 13.
    Leahy A, Besherdas K, Clayman C, Mason I, Epstein O: Abnormalities of the electrogastrogram in functional gastrointestinal disorders. Am J Gastroenterol. 94(4):1023–1028, 1999Google Scholar
  14. 14.
    Sarna SK: Gastrointestinal electrical activity: terminology. Gastroenterology 68:1361–1365, 1975Google Scholar
  15. 15.
    Hinder RA, Kelly KA: Human gastric pacesetter potential. Site of origin, spread and response to gastric transection and proximal gastric vagotomy. Am J Surg 133:29–33, 1978Google Scholar
  16. 16.
    Lin Z, Eaker EY, Sarosiek I, McCallum RW. Gastric myoelectrical activity and gastric emptying in patients with functional dyspepsia. Am J Gastroenterology 94(9):2384–2389, 1999Google Scholar
  17. 17.
    Brzana RJ, Koch KL, Binaman S: Gastric myoelectrical activity in patients with gastric outlet obstruction and idiopathic gastroparesis. Am J Gastroenterol 93(10):1803–1809, 1998Google Scholar
  18. 18.
    Hu S, Stern RM: Optokinetic nystagmus correlates with severity of vection-induced motion sickness and gastric tacharrythmia. Aviat Space Environ Med 69(12):1162–1165, 1998Google Scholar
  19. 19.
    You CH, Lee KY, Chey WY, Menguy R. Electrogastrographic study of patients with unexplained nausea, bloating, and vomiting. Gastroenterology 79:311–314, 1980Google Scholar
  20. 20.
    Park S, Hooper F, Palaniappan J, Owyang C, Hasler W: Rectogastric reflex-induced gastric hypersensitivity and gastric slow wave dysrhythmias with mechanical distention and meal ingestion: a model for dyspepsia with functional lower gut disorders. The program of the sixth International Workshop on Electrogastrography, New Orleans, May 1998, p42 (abstract)Google Scholar
  21. 21.
    Chen J: A computerized data analysis system for electrogastrogram. Comp Biomed Eng. 40:128–135, 1993Google Scholar
  22. 22.
    Chen JDZ, Richaeds RD, McCallum RW: Identification of gastric contractions from the cutaneous electrogastrogram. Am J Gastroenterology. 89:79–85, 1994Google Scholar
  23. 23.
    Pearcy JF, Van Liere EJ: Studies on the visceral nervous system XII. Reflexes from colon. Am J Physiol 78:64–73, 1926Google Scholar
  24. 24.
    Chen JD, Pan J, McCallum RW: Clinical significance of gastric myoelectrical dysrhythmias. Dig Dis Sci 13(5):275–290, 1995Google Scholar
  25. 25.
    Pfaffenbach B, Adamek RJ, Bartholomaus C, Wegener M: Gastric dysrhythmias and delayed gastric emptying in patients with functional dyspepsia. Dig Dis Sci 42(10):2094–2099, 1997Google Scholar
  26. 26.
    Devane SP, Ravelli AM, Bisset WM, Smith VV, Lake BD, Milla PJ: Gastric antral dysrhythmias in children with chronic idiopathic intestinal pseudo-obstruction. Gut 33(11):1477–1481, 1992Google Scholar
  27. 27.
    Cucchiara S, salvia G, Borrelli O, Ciccimarra E, Az-Zeqeh N, Rapagiolo S, Minella R, Campanozzi A, Riezzo G. Gastric electrical dysrythmias and delayed gastric emptying in gastroesophageal reflux disease. Am J Gastroenterol 92(7):1103–1108, 1997Google Scholar
  28. 28.
    Cucchiana S, Franzese A, Salivia G, Alfonis L, Lula VD, Montisci A, Moreira FL: Gastric emptying delay and gastric myoelectrical derangement in IDDM. Diabetes Care 21(3):438–443, 1998Google Scholar
  29. 29.
    Abell TL, Camiller M, Hench VS, Malagelada JR: Gastric electromechanical function and gastric emptying in diabetic gastroparesis. Eur. J. Gastroenterol Hepatol 3:163–167, 1991Google Scholar
  30. 30.
    Masaki A, Kono T, Wang ZS, Chen JDZ: Impairment of gastric and jejunal myoelectrical activity during rectal distention in dogs. Dig Dis Sci 45:1731–1736, 2000Google Scholar
  31. 31.
    Gue, M, Junien JL, Bueno L: The K agonist fedotozine modulates colonic distention-induced inhibition of gastric motility and emptying in dogs. Gastroenterology. 107:1327–1334, 1994Google Scholar
  32. 32.
    Azpiroz F, Malagelada JR: Perception and reflex relaxation of the stomach in response to gut distention. Gastroenterology 98:1193–1198, 1990Google Scholar
  33. 33.
    Grundy D, Scratcherd T: A splanchno-vagal component of the inhibition of gastric motility by distention of the intestine. In Motility of the Digestive tract. M Weinbeck, ed. New York: Raven Press, 1982, 39–43.Google Scholar
  34. 34.
    Sims MA, Hasler WL, Chey WD, Kim MS, Owyang C: Hyperglycemia inhibits mechanoreceptor-mediated gastriocolonic response and colonic peristaltic reflex in healthy humans. Gastroenterology 108:350–359, 1995Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Liwei Qian
    • 1
  • William C. Orr
    • 2
  • J.D.Z. Chen
    • 1
  1. 1.Lynn Institute for Healthcare ResearchOklahoma CityUSA
  2. 2.Division of Gastroenterology, Department of Internal MedicineUniversity of Texas Medical BranchGalvestonUSA

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