Coordinated motor activity of the human gastroduodenal region

Abstract

Using real-time ultrasonic imaging, and a test meal of 500 ml of dilute orange juice, we have studied the temporal relationships among contractions of the terminal antrum, pylorus, and proximal duodenum of 22 normal subjects. A total of 259 cyclical periods of motor activity were observed. Individual mean gastroduodenal cycle times ranged from 17.9 to 29.6 seconds (2.0–3.3 cycles/min). Terminal antral contractions (TACs) were observed 98% of cycles and pyloric closure invariably occurred at the midpoint of these contractions. The pylorus then opened as the terminal antrum relaxed and remained open until the next TAC. Only 67% of TACs were associated with contractions of the proximal duodenum (DC), but 94% of these occurred about 1 sec (range 1 sec before to 2 sec after) after pyloric closure. Only 6% of DCs were ectopic, in that their occurrence was apparently uncoordinated with the TACs. Our observations demonstrate that after ingestion of a test meal, the human terminal antrum, pylorus, and proximal duodenum usually contract in sequential coordinated manner, presumably under the control of the gastric slow wave. No evidence of independent pyloric closure was obtained.