motilin and Colonic-Diseases--Functional

In irritable bowel syndrome (IBS), motility disturbances occur from the upper gastrointestinal tract to the distal colon, where regulatory peptides have a wide-spread distribution. Studies on basal and postprandial plasma levels of different gut hormones show that VIP, CCK, and motilin may be closely related to the symptoms including abdominal pain, diarrhea and constipation. In addition, peptide YY and NPY have effects on absorption in the intestine, and some opioid peptides exert actions on colonic motility in IBS patients. Recent studies revealed that gall bladder in IBS has an abnormal sensitivity to CCK-8, indicating that IBS patients has an generalized abnormality of the smooth muscle of the digestive tract. Gut hormones, which act as hormones, neurotransmitters and neuromodulators depending on their releasing site, may therefore play an important role in IBS patients.

Topics: Animals; Cholecystokinin; Colonic Diseases, Functional; Gastrointestinal Motility; Humans; Motilin; Neuropeptide Y; Peptide YY; Peptides; Rats; Rats, Sprague-Dawley; Vasoactive Intestinal Peptide

Visceral hypersensitivity is a feature of the irritable bowel syndrome (IBS). Postprandial symptoms are common in these patients. The effects of nutrients on colonic perception in IBS are incompletely understood.. We studied 13 healthy subjects and 16 patients with IBS-eight had diarrhoea predominant (IBS-D) and eight constipation predominant (IBS-C) IBS.. Colonic perception thresholds to balloon distension and viscerosomatic referral pattern were assessed before and after duodenal infusion of lipid or saline, respectively. At the end of the infusions, plasma levels of gastrointestinal peptides were determined.. Lipids lowered the thresholds for first sensation, gas, discomfort, and pain in the IBS group but only for gas in the control group. The percent reduction in thresholds for gas and pain after lipids was greater in the IBS and IBS-D groups but not in the IBS-C group compared with controls. IBS patients had an increased area of referred discomfort and pain after lipids compared with before infusion whereas the referral area remained unchanged in controls. No group differences in colonic tone or compliance were observed. In both groups higher levels of cholecystokinin, pancreatic polypeptide, peptide YY, vasoactive intestinal polypeptide, and neuropeptide Y were seen after lipids. Motilin levels were higher in patients and differences in the subgroups were observed. Levels of corticotrophin releasing factor were lower in the constipated group than in the diarrhoea group.. Postprandial symptoms in IBS patients may be explained in part by a nutrient dependent exaggerated sensory component of the gastrocolonic response.

Topics: Adult; Analysis of Variance; Case-Control Studies; Catheterization; Cholecystokinin; Colon; Colonic Diseases, Functional; Constipation; Diarrhea; Dietary Fats; Female; Humans; Male; Middle Aged; Motilin; Neuropeptide Y; Pain Threshold; Pancreatic Polypeptide; Peptide YY; Postprandial Period; Pressure; Statistics, Nonparametric; Stomach; Vasoactive Intestinal Peptide

The irritable bowel syndrome (IBS) is associated with motor abnormalities in the small intestine and colon. Neuropeptides may have an important role in initiating and regulating the intestinal motility. Motilin has been proposed to initiate the peristaltic reflex in the small intestine and cholecystokinin the gastrocolic reflex.. In 18 patients with IBS and 11 healthy control subjects plasma motilin and cholecystokinin (CCK) concentrations were measured after intraluminal stimulation of water and a fat-rich meal.. The IBS patients had reduced motilin secretion after both water intake and the fat meal. In contrast, the fat meal elicited an exaggerated and prolonged CCK release in the IBS patients.. Disturbed motilin and CCK release may partly be responsible for the intestinal dysmotility in the IBS patients.

Topics: Adult; Case-Control Studies; Cholecystokinin; Colonic Diseases, Functional; Dietary Fats; Drinking; Female; Humans; Male; Motilin; Radioimmunoassay

Effects of an artificial mental stress on colonic motility, autonomic nervous system, and gastrointestinal hormones were examined in patients with irritable bowel syndrome (IBS). The subjects were 20 patients with typical IBS and 12 controls. A transducer was inserted to the sigmoid colon from the anus for measuring colonic intraluminal pressure, and mirror drawing test was loaded as psychological stress. At the same time, coefficient of variation of R-R interval on ECG (CV-RR) was measured and the levels of plasma catecholamines, gastrin, glucagon, and motilin were assessed. Colonic motility showed a significant increase in the IBS patients during the stress compared with that in controls (p less than 0.01). Motilin also increased significantly in the IBS patients after the stress (p less than 0.01). CV-RR and motilin revealed positive relationship with colonic motility alteration in the IBS patients although no significant change was detected in controls. These phenomena are thought to be due to autonomic nervous dysfunction and/or gastrointestinal hormonal derrangments induced by psychological stress. It is suggested that organ specificity of the alimentary tract for the stress exists in this disease.

Topics: Adolescent; Adult; Autonomic Nervous System; Blood Pressure; Catecholamines; Colon; Colonic Diseases, Functional; Female; Gastrointestinal Hormones; Gastrointestinal Motility; Heart Rate; Humans; Male; Middle Aged; Motilin; Stress, Psychological

Motilin, pancreatic polypeptide and gastrin blood concentrations in response to drinking water have been studied in 40 patients with functional bowel disease and compared with results in two groups of healthy control subjects. Patients with slow transit constipation and idiopathic megacolon showed impaired motilin release. Pancreatic polypeptide release was reduced in patients with slow transit constipation, but increased in those with functional diarrhoea. Gastrin release was impaired in all groups complaining of chronic constipation. Circulating motilin, pancreatic polypeptide and gastrin concentrations appear to bear some relationship to intestinal transit time in patients with functional bowel disorders.

Topics: Adult; Colonic Diseases, Functional; Constipation; Diarrhea; Drinking; Female; Gastrins; Humans; Intestinal Diseases; Male; Megacolon; Middle Aged; Motilin; Pancreatic Polypeptide; Water

In order to investigate the possible involvement of gastrointestinal hormones in functional disorders of the digestive tract, serum motilin, neurotensin and gastrin levels in their response to oral intake of fat and glucose were examined in patients with irritable colon syndrome and dumping syndrome. The following results were obtained. (1) Basal serum motilin levels were higher in patients with irritable colon syndrome than in normal subjects, and remained high after ingestion of either 50 g of butter or 50 g of glucose. (2) No consistent response in serum neurotensin levels was found in patients with irritable colon syndrome or in normal subjects. (3) An immediate increase in serum gastrin levels was found in response to fat ingestion both in patients with irritable colon syndrome and in normal subjects, but there was no difference between these two groups. (4) In a patient with typical dumping syndrome, a markedly high level of fasting serum motilin was found, and the level increased further after the oral intake of glucose. These findings suggest that motilin may be involved in the irritable colon syndrome and dumping syndrome.

Topics: Adult; Colonic Diseases; Colonic Diseases, Functional; Dietary Fats; Fasting; Gastrins; Gastrointestinal Hormones; Glucose; Humans; Motilin; Neurotensin