Skip to main content
SpringerLink
Log in

Gastrobiliary motility after liquid fatty meal in progressive systemic sclerosis

A sonographic study

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

Abstract

Gastric emptying, antral motility, and gallbladder emptying after a liquid fatty meal were studied by ultrasound in 25 patients with progressive systemic sclerosis and in 25 sex- and age-matched controls. In patients with systemic sclerosis, the possible role of autonomic dysfunction was evaluated by four noninvasive cardiovascular reflex tests. Despite a significant delay of gastric emptying and a significant postprandial antral hypomotility in the patients with systemic sclerosis, the fat-induced gallbladder emptying was only slightly reduced, reaching no significant level when compared to the controls. The prolongation of gastric emptying correlated significantly with the duration of the disease. Although 36% of the patients in the systemic sclerosis group exhibited signs of autonomic cardiac dysfunction, there was no evidence of an association between these signs and gastric motor dysfunction. In conclusion motility disorders of the gallbladder seem to play a minor role in the upper gut involvement of systemic sclerosis, whereas motility disorders of the stomach are frequent and can be easily recognized noninvasively by real-time ultrasound.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Leroy EC: Scleroderma (Systemic Sclerosis). Textbook of Rheumatology. New York, WB Saunders, 1985, pp 1183–1205

    Google Scholar 

  2. Cohen S, Lauffer I, Snape WJ, Shian YF, Levine GM, Jimenez S: The gastrointestinal manifestations of scleroderma: Pathogenesis and management. Gastroenterology 79:155–166, 1980

    PubMed  Google Scholar 

  3. Akesson A, Gustavson T, Wollheim F, Brismar J: Esophageal Dysfunction and radionuclide transit time in progressive systemic sclerosis. Scand J Rheumatol 16:291–299, 1987

    PubMed  Google Scholar 

  4. Atkinson M, Summerling MD: Oesophageal changes in systemic sclerosis. Gut 7:402–408, 1966

    PubMed  Google Scholar 

  5. Bortolotti M, Turba E, Tosti A, Sarti P, Brunelli F, Del Campo L, Barbara L: Gastric emptying and interdigestive antroduodenal motility in patients with esophageal scleroderma. Am J Gastroenterol 86:743–747, 1991

    PubMed  Google Scholar 

  6. Greydanus MP, Camilleri M: Abnormal postcibal antral and small bowel motility due to neuropathy or myopathy in systemic sclerosis. Gastroenterology 96:110–115, 1989

    PubMed  Google Scholar 

  7. Maddern GJ, Horowitz M, Jamieson GG, Chatterboy BE, Collins PJ, Robah-Thomson P: Abnormalities of esophageal and gastric emptying in progressive systemic sclerosis. Gastroenterology 87:922–926, 1984

    PubMed  Google Scholar 

  8. Hamel-Roy J, Devroede G, Arhan P, Tetreault L, Duranceau A, Menard HA: Comparative esophageal and anorectal motility in scleroderma. Gastroenterology 88:1–7, 1985

    PubMed  Google Scholar 

  9. Whitehead WE, Taitelbaum G, Wighley FM, Schuster MM: Rectosigmoid motility and myoelectric activity in progressive systemic sclerosis. Gastroenterology 96:428–432, 1989

    PubMed  Google Scholar 

  10. Salen G, Goldstein F, Wirts W: Malabsorption in intestinal scleroderma. Relation to bacterial flora and treatment with antibiotics. Ann Intern Med 64:834–841, 1966

    Google Scholar 

  11. Zamost BJ, Hirschberg J, Ippoliti AF: Esophagitis in scleroderma. Prevalence and risk factors. Gastroenterology 92:421–428, 1987

    PubMed  Google Scholar 

  12. Drane WE, Karvelis K, Johnson DA, Curran JJ, Silverman ED: Progressive systemic sclerosis: radionuclide esophageal scinitigraphy and manometry. Radiology 160:73–76, 1986

    PubMed  Google Scholar 

  13. Bolondi L, Bortolotti M, Santi V, Calletti T, Gaiani S, Labo G: Measurement of gastric emptying time by real-time ultrasound. Gastroenterology 89:752–759, 1985

    PubMed  Google Scholar 

  14. Holt S, Cervantes J, Wilkinson AA, Wallace JHK: Measurement of gastric emptying rate in humans by real time ultrasound. Gastroenterology 90:918–923, 1986

    PubMed  Google Scholar 

  15. Sauer W, Pfeffer F, Reuland P: Evaluierung von zwei einfachen Verfahren zur sonographischen Erfassung der Magenentleerung (Evaluation of 2 simple sonographic methodes for examination of gastric emptying). Ultraschall 9:299–302, 1989

    Google Scholar 

  16. Wedmann B, Schaffstein J, Wegener M, Schmidt G, Coenen C, Ricken D: Sonographische Erfassung der Magenentleerung. Reliabilität und Validität der Antrumflächenmethode für Flüssigkeiten (sonographic detection of gastric emptying). Z Gastroenterol 28:448–452, 1990

    PubMed  Google Scholar 

  17. Holt S, McDicken WN, Anderson T, Stewart IC, Heading RC: Dynamic imaging of the stomach by real-time ultrasound—a method for the study of gastric motility. Gut 21:597–601, 1980

    PubMed  Google Scholar 

  18. Vogelberg KH, Rathmann W: Sonographische Kriterien zur Untersuchung der Magenmotilität bei Diabetikern mit autonomer Neuropathie. Dtsch Med Wochenschr 111:1687–1691, 1986

    PubMed  Google Scholar 

  19. Wedmann B, Adamek RJ, Wegener M: Sonographische Beurteilung Magenantrummotilität—Evaluierung einer vereinfachten Methode. Ultraschall 13:1992 (in press)

  20. Wedmann B, Schmidt G, Wegener M, Coenen C, Ricken D, Dröge C: Sonographic evaluation of gallbladder kinetics:In vitro andin vivo comparison of different methods to assess gallbladder emptying. J Clin Ultrasound 19:341–349, 1991

    PubMed  Google Scholar 

  21. Copeman PWM, Medd WE: Diffuse systemic sclerosis with abnormal liver and gallbladder wall. Br Med J 3:353–354, 1967

    PubMed  Google Scholar 

  22. Gautschy B, Weidmann P, Gnädinger MP: Autonomic function tests as related to age and gender in normal man. Klin Wochenschr 64:499–505, 1986

    PubMed  Google Scholar 

  23. Gries FA, Cicmir I, Berger H: Autonome diabetische Neuropathie am Herzen-klinische Zeichen und diagnostische Möglichkeiten.In Herz und Diabetes—Diabetes und Herz. O Gleichmann (ed). Darmstadt, Steinkopf Verlag, 1986, pp. 21–24

    Google Scholar 

  24. Wedmann B, Schmidt G, Wegener M, Coenen C, Ricken D, Althoff J: Effects of age and gender on fat-induced gallbladder contraction and gastric emptying of a caloric liquid meal: A sonographic study. Am J Gastroenterol 86:1765–1770, 1991

    PubMed  Google Scholar 

  25. Klimiuk PS, Taylor L, Baker RD, Jayson M: Autonomic neuropathy in systemic sclerosis. Ann Rheum Dis 47:542–545, 1988

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 4630, Bochum, Germany

    B. Wedmann MD, M. Wegener MD, R. J. Adamek MD & S. El Gammal MD

Authors
  1. B. Wedmann MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Wegener MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. J. Adamek MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. El Gammal MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wedmann, B., Wegener, M., Adamek, R.J. et al. Gastrobiliary motility after liquid fatty meal in progressive systemic sclerosis. Digest Dis Sci 39, 565–570 (1994). https://doi.org/10.1007/BF02088344

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02088344

Key words

Search

Navigation