motilin and Diarrhea

Topics: Biomarkers; Constipation; Diabetes Mellitus; Diagnostic Techniques, Endocrine; Diarrhea; Duodenal Ulcer; Gastrointestinal Motility; Humans; Inflammatory Bowel Diseases; Kidney Failure, Chronic; Motilin; Radioimmunoassay; Receptors, Gastrointestinal Hormone; Receptors, Neuropeptide; Reference Values; Specimen Handling

Topics: Animals; Bile Acids and Salts; Carboxylic Acids; Diabetes Complications; Diarrhea; Fatty Acids; Female; Humans; Intestine, Small; Male; Motilin

There is increasing evidence that digestive hormones are involved in the regulation of the gastrointestinal motor profile in man. A typical profile of postprandial activity corresponding to the continuous occurrence of irregular contractions propagated over short distance is accompanied by an increase in plasma level of 8 to 10 identified digestive hormones. Four of them (insulin, gastrin, neurotensin and CCK8) infused systemically may produce or prolong this typical "fed" pattern suggesting that they may be involved physiologically in the initiation and duration of the fed pattern. The fasted state is characterized by the cyclic occurrence of gastrointestinal migrating motor complexes (MMC) which are associated with cyclic changes in plasma levels of motilin, somatostatin pancreatic polypeptide and gastrin. Numerous recent findings support the hypothesis that an increase in motilin initiates the MMC at foregut level which, in turn, produces the release of somatostatin. These hormones may be responsible for the aboral migration of MMC from the duodenum to the ileum and for the cycling rhythm by affecting blood levels of motilin (and/or) pancreatic polypeptide.

Topics: Animals; Celiac Disease; Circadian Rhythm; Diarrhea; Dogs; Gastrointestinal Hormones; Gastrointestinal Motility; Humans; Motilin; Pancreatic Hormones

Information concerning GEP hormones has progressively advanced since the initial discovery of a GEP hormone, secretin, in 1902. Studies in this area flourished with the advent of radioimmunoassay, and have provided an understanding of the secretion, regulation, metabolic actions, and role in certain diseases of major GEP hormones. Measurement of GEP hormones has achieved importance in clinical medicine and allowed understanding of the pathophysiology of several clinical disorders. The decade to come should witness additional advances in this rapidly expanding field.

Topics: Chemical Phenomena; Chemistry; Cholecystokinin; Diabetes Mellitus; Diarrhea; Endocrine System Diseases; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Hypoglycemia; Motilin; Neoplasms; Neurotensin; Pancreatic Polypeptide; Peptic Ulcer; Secretin; Skin Diseases; Somatostatin; Substance P; Vasoactive Intestinal Peptide

Postoperative gastrointestinal tract dysfunction is considered a common complication affecting patients undergoing intestinal surgery. This research aims to provide evidence to assess the efficacy and safety of Baizhu Shaoyao San (BSS) or modified BSS in treating postoperative diarrhea of colorectal cancer patients.. Eighty patients with colorectal cancer were randomized within 2 weeks after surgery to receive either modified BSS or Loperamide combined with the respective dummy. The curative effect was evaluated with the traditional Chinese medicine (TCM) syndrome score. Determination of motilin and gastrin in plasma was conducted utilizing ELISA.. Compared with Loperamide therapy, the efficacy of modified BSS was statistically significant, the TCM syndrome score decreased, and the total effective rate increased. Levels of motilin and gastrin in plasma decreased.. The curative effect and safety of modified BSS were statistically significant.

Topics: Colorectal Neoplasms; Diarrhea; Gastrins; Gastrointestinal Diseases; Humans; Loperamide; Motilin; Single-Blind Method

it was aimed to investigate the efficacy and safety of cupping moxibustion in patients with functional diarrhea. 51 patients diagnosed with functional diarrhea from January 2021 to December 2021 were selected as the objects, and they were randomly divided into the control group (oral montmorillonite powder) and the experiment group (oral montmorillonite powder combined with cupping moxibustion). The number of diarrheas, Bristol stool, traditional Chinese medicine (TCM) syndromes, clinical efficacy indexes, self-rating anxiety scale (SAS) score, the MOS item short from health survey (SF-36) scale score, peripheral blood cell levels of CD4+, CD8+, and Th17, gastrin (GAS), motilin (MTL), and cholecystokinin (CCK) levels was assessed before and after treatment. The adverse events were also recorded. Compared with those before treatment, all indexes of both groups were significantly improved (P<0.05). Compared with those of the control group, the number of diarrheas, Bristol stool, TCM syndrome score, SAS score, and CD8+ cell levels was significantly decreased after treatment in the experiment group (P<0.05). The clinical cure rate (48.0% vs. 73.1%), SF-36 score, GAS, MTL, CCK contents, and CD4+, and Th17 cell levels were significantly increased (P<0.05). No significant difference was in the incidence of adverse events between the two groups (P>0.05). It could be suggested that cupping moxibustion could be applied in the treatment of functional diarrhea, improving the clinical symptoms, relieving anxiety, enhancing gastrointestinal and immune functions, and promoting the quality of life of patients significantly.

Topics: Bentonite; Cholecystokinin; Diarrhea; Gastrins; Humans; Immunity; Motilin; Moxibustion; Powders; Quality of Life

To observe the effects of Xingpi Yang'er Granule (XYG) on serum gastrin (GAS), plasma motilin (MOT), and somatostatin (SS) in children patients with pneumonia induced diarrhea.. Recruited were 120 children inpatients with pneumonia induced diarrhea at the Department of Pediatrics, Liaocheng People's Hospital from June 2011 to June 2012. They were randomly assigned to two groups, the treatment group and the control group, 60 in each group. Those in the treatment group were treated with XYG, while those in the control group were treated with Live Combined Bifidobacterium and Lactobacillus Tablets. Besides, 30 healthy children who received physical examinations at our hospital were recruited as the healthy control group. The clinical efficacy, changes of GAS, MOT, and SS contents were observed.. The total effective rate was 95.0% in the treatment group and 93.3% in the control group, showing no statistical difference (P > 0.05). Compared with healthy control group, the GAS and MOT contents increased, and SS decreased before treatment in the other two groups (P < 0.05). Compared with the same group before treatment, GAS and MOT contents obviously decreased, and SS increased in the other two groups after treatment (P<0.05). Compared with the control group at the same time point, GAS and MOT decreased, and SS increased in the treatment group after treatment, showing statistical differences (P < 0.05).. The levels of GAS, MOT, and SS were obviously changed in children patients with pneumonia induced diarrhea. XYG had obvious regulation on their GAS, MOT and SS contents.

Topics: Child, Preschool; Diarrhea; Drugs, Chinese Herbal; Female; Gastrins; Humans; Infant; Male; Motilin; Phytotherapy; Pneumonia; Somatostatin

To observe the therapeutic efficacy of acupoint heat-sensitization moxibustion on chronic diarrhea patients as well as its effects on the levels of gastrointestinal neurotic mediators such as serum gastrin (GAS) and plasma motilin (MTL).. Sixty chronic diarrhea patients of Pi-Shen deficiency syndrome were randomly assigned to Group A (30 cases, treated with acupoint heat-sensitization moxibustion, once daily) and Group B (30 cases, treated with Changtai Oral Liquid, 10 mL each time, three times daily). The therapeutic course was 4 weeks. Another 20 healthy volunteers were recruited as the health control group. The levels of serum GAS and plasma MTL were detected using radioimmunoassay before and after treatment. The cured rate, the markedly effective case, the effective case, the ineffective case, and the total effective rate were calculated by the end of the treatment.. Before treatment the serum GAS level was lower and the plasma MTL level higher in the two patient groups than in the health control group with statistical difference (P<0.05). There was no statistical difference in the symptom integral between the two patient groups and the health control group (P>0.05). After treatment the serum GAS level increased, the plasma MTL level and the symptom integral decreased in the two patient groups, showing statistical difference when compared with the same group before treatment (P<0.05, P<0.01). After treatment the symptom integral was lower in the treatment group than in the control group with statistical difference (P<0.05). There was no statistical difference in the GAS and MTL levels between the two patient groups (P>0.05). The total effective rate for clinical symptoms was significantly higher in Group A than in Group B with statistical difference (93.3% vs 73.3%, P<0.05).. The therapy of acupoint heat-sensitization moxibustion was effective for chronic diarrhea patients of Pi-Shen deficiency syndrome. It could regulate the levels of serum GAS and plasma MTL and improve the patients' clinical symptoms.

Topics: Adult; Case-Control Studies; Chronic Disease; Diarrhea; Female; Gastrins; Humans; Male; Medicine, Chinese Traditional; Middle Aged; Motilin; Moxibustion; Single-Blind Method; Yang Deficiency; Yin Deficiency

To observe the effect of Jianpi Wenshen Decoction (JWD) on serum gastrin, plasma motilin and somatostatin in patients of diabetic diarrhea (DD).. Patients with DD were randomly divided into two groups, the JWD group and the control group treated with Loperamide (LPA). Besides, a normal control group was set up. Changes of serum gastrin, plasma motilin and somatostatin were observed.. Before treatment, the levels of gastrin and motilin in both groups were higher and somatostatin lower than those in the normal control group. After 1 month treatment, levels of the three indices were restored in both group approaching the normal range with insignificance as compared with those in the normal control group (P > 0.05). Level of plasma motilin and serum gastrin showed an increasing trend along with the therapeutic effect elevation, while level of somatostatin showed a decreasing trend.. JWD could promote the recovery of the impaired function of vegetative nerve system in DD patients. At the same time, serum gastrin, plasma motilin and somatostatin may be taken as the indexes for evaluating the efficacy in treating DD.

Topics: Adult; Aged; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diarrhea; Drugs, Chinese Herbal; Female; Gastrins; Humans; Male; Middle Aged; Motilin; Phytotherapy; Somatostatin

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

Previous studies showed increased plasma motilin and substance P concentrations and accelerated motor function in the small bowel and colon in patients with carcinoid diarrhea. Octreotide is beneficial in patients with carcinoid syndrome. Our hypothesis was that octreotide inhibits accelerated motility and gut neuropeptides in carcinoid syndrome.. In 12 patients with metastatic carcinoid syndrome, we investigated the effect of octreotide 50 microg s.c. t.i.d (n = 6) or placebo (n = 6) on postprandial symptoms, GI transit, colonic motility, and circulating levels of selected circulating peptides and amines.. Octreotide reduced postprandial flushing (p = 0.03) but not pain. Octreotide significantly retarded overall colonic transit and proximal colonic emptying (p < 0.05); it tended to prolong small bowel transit time (p = 0.13) and to reduce postprandial colonic tone (p = 0.08) compared with placebo. Octreotide also reduced circulating levels of peptide YY, neurotensin, vasoactive intestinal polypeptide, and substance P but had no effect on plasma motilin, neuropeptide Y, calcitonin gene-related peptide, or histamine after meal ingestion.. Octreotide ameliorates gut motor dysfunctions that characterize carcinoid diarrhea; the potential role of specific antagonism of serotonin, substance P, and vasoactive intestinal polypeptide alone or in combination with agents that inhibit their release in carcinoid diarrhea deserves further study.

Topics: Aged; Antineoplastic Agents, Hormonal; Calcitonin Gene-Related Peptide; Colon; Colonic Diseases; Diarrhea; Digestion; Double-Blind Method; Female; Flushing; Gastrointestinal Agents; Gastrointestinal Motility; Gastrointestinal Transit; Histamine; Humans; Intestine, Small; Male; Malignant Carcinoid Syndrome; Middle Aged; Motilin; Neuropeptide Y; Neuropeptides; Neurotensin; Octreotide; Peptide YY; Placebos; Serotonin Antagonists; Substance P; Vasoactive Intestinal Peptide

The effect of xylitol and glucose on the rate of gastric emptying and intestinal transit and on motilin, gastric inhibitory polypeptide (GIP), and insulin release were studied in human volunteers. A single oral dose of 200 mL water containing 30 g glucose or 30 g xylitol, mixed with a 99mtechnetium-tin (99mTc-Sn) colloid, was used. Similar dosing without the label was used in motilin, GIP, and insulin studies. Xylitol decreased the rate of gastric emptying but concomitantly accelerated intestinal transit compared with glucose. The half-times for gastric emptying were 77.5 +/- 4.6 and 39.8 +/- 3.4 min after ingestion of xylitol and glucose solutions, respectively. Glucose suppressed motilin and stimulated GIP secretion; xylitol stimulated motilin secretion but had no effect on GIP, which is currently the main candidate for the role of enterogastrone. The accelerated intestinal transit and increase in plasma motilin observed after xylitol ingestion were thought to be causally related to the diarrhea and gastrointestinal discomfort produced by it.

Topics: Colloids; Diarrhea; Female; Gastric Emptying; Gastric Inhibitory Polypeptide; Glucose; Humans; Insulin; Insulin Secretion; Kinetics; Male; Motilin; Technetium; Technetium Compounds; Tin; Tin Compounds; Xylitol

Topics: Constipation; Diabetes Mellitus; Diarrhea; Humans; Inflammatory Bowel Diseases; Motilin; Radioimmunoassay

To investigate the underlying mechanisms of Berberine-mediated antidiarrheal effects in thyroid hormone-induced diarrhea in rats, gastrointestinal peptides, such as motilin, gastrin, vasoactive intestinal peptide, and somatostatin from plasma and tissue of hyperthyroid diarrheic rats were measured using radioimmunoassay in healthy control, model, and treated model groups. The number and volume of goblet cells were also observed. Compared with healthy control, hyperthyroid diarrheic rats exhibited a significant reduction in body weight, and increase in plasma concentrations of tri-iodothyronine and free thyroxine along with the increase of wet stool. Both plasma motilin and gastrin were also elevated and reduced remarkably in Berberine-treated subgroup along with the body weight increased and wet stool reduced at the meantime. Significant changes in plasma vasoactive intestinal peptide and somatostatin were not seen. Gastrointestinal peptides trend in tissue samples were similar to those observed in plasma. Morphological data demonstrated an increase in number and/or volume of goblet cells to some extent in duodenum, jejunum, ileum, and colon, respectively and decreased by administration of Berberine. The possible underlying mechanisms of antidiarrheal effects of Berberine may be due in partially to the reduction of the number of goblet cells and the amount of mucous secretion through re-balancing gastrointestinal peptides.

Topics: Animals; Antidiarrheals; Berberine; Colon; Diarrhea; Duodenum; Gastrins; Gastrointestinal Hormones; Goblet Cells; Hyperthyroidism; Jejunum; Male; Motilin; Radioimmunoassay; Rats; Rats, Sprague-Dawley; Somatostatin; Thyroid Hormones; Vasoactive Intestinal Peptide

The pharmacological properties of MA-2029, a selective and competitive motilin receptor antagonist, were investigated in conscious dogs after oral administration. Gastrointestinal contractile activity was recorded by chronically implanted force transducers. The proximal gastric volume was measured with a barostat under constant pressure. Gastric emptying was examined using the paracetamol absorption test. MA-2029 (0.3-10 mg/kg, p.o.) administered in the interdigestive state inhibited gastrointestinal contractions induced by motilin (3 microg/kg, i.v.) in a dose-dependent manner. MA-2029 (0.3-3 mg/kg, p.o.) also inhibited the occurrence of spontaneous phase III contractions, even though MA-2029 had no effect on basal gastrointestinal motility or basal gastric emptying even at 10 and 30 mg/kg p.o. The inhibitory effect of MA-2029 on motilin-induced gastrointestinal motility corresponded to its plasma concentration. Motilin (0.3 microg/kg/h, i.v. infusion) reduced the proximal gastric volume by about 50% of control during isobaric distension. This effect was also inhibited by MA-2029 (1-10 mg/kg, p.o.) in a dose-dependent manner. In the digestive state, injection of motilin (3 microg/kg, i.v.) induced diarrhea in 9 of 11 dogs. MA-2029 (1-30 mg/kg, p.o.) reduced the incidence of diarrhea induced by motilin in a dose-dependent manner. The results indicate that MA-2029 inhibits hypermotility induced by motilin in conscious dogs without having an effect on the basal gastrointestinal tone or gastric emptying rate. MA-2029 may be useful in treating gastrointestinal disorders in which the pathogenesis involves the elevation of circulating motilin.

Topics: Administration, Oral; Animals; Diarrhea; Dogs; Dose-Response Relationship, Drug; Female; Gastric Emptying; Gastric Fundus; Gastrointestinal Agents; Gastrointestinal Motility; Male; Motilin; Muscle Contraction; Muscle Tonus; Muscle, Smooth; Oligopeptides; Receptors, Gastrointestinal Hormone; Receptors, Neuropeptide

The prokinetic effects of mitemcinal, an orally active motilin receptor agonist, on the lower gastrointestinal tracts were investigated in conscious dogs. Oral administration of mitemcinal (0.1-1 mg/kg) stimulated colonic motility, which was measured by chronically implanted force-transducers, as well as gastric motility in a dose-dependent manner. The gastrointestinal contractile activities induced by mitemcinal were inhibited by the continuous intravenous infusion of GM-109, a selective motilin receptor antagonist. Oral administration of mitemcinal (0.3-3 mg/kg) also accelerated bowel movement after feeding without inducing diarrhea in dogs. The results demonstrate that mitemcinal stimulates colonic motility via motilin receptors and the effect of mitemcinal on colonic motility may reflect bowel movement after feeding. Thus, mitemcinal could be a promising agent for treatment of not only the upper but also the lower gastrointestinal motility disorders.

Topics: Administration, Oral; Animals; Colon; Defecation; Diarrhea; Dogs; Dose-Response Relationship, Drug; Erythromycin; Female; Gastrointestinal Motility; Male; Motilin; Muscle Contraction; Receptors, Gastrointestinal Hormone; Receptors, Neuropeptide

The effects of mitemcinal (GM-611), an orally active motilin agonist, on defecation were investigated in rabbits and dogs. In normal rabbits, within 0-3 h of dosing, orally administered mitemcinal (2.5-10 mg kg(-1)) increased stool weight in a dose-dependent manner without causing loose stools. Sennoside (12-48 mg kg(-1)) also facilitated defecation within 2-9 h of oral administration, but the stools were significantly loosened. In the morphine-induced constipation model, the stool weight of morphine-treated rabbits (1 mg kg(-1)) was only 37.5% of that of untreated animals. Mitemcinal (0.5-20 mg kg(-1)) dose-dependently increased stool weight without increasing stool water content. At the highest dose of mitemcinal, stool weight recovered to 83.9% of that of untreated animals. In normal dogs, mitemcinal (0.3-3 mg kg(-1)) reduced the time to first bowel movement after oral administration without inducing diarrhoea at any dose. These results indicate that mitemcinal facilitates defecation without inducing severe diarrhoea. It is suggested that mitemcinal may be a novel therapeutic agent for constipation that enables easier control of the timing of defecation because of the early onset and short duration of its action, compared with sennoside.

Topics: Animals; Constipation; Defecation; Diarrhea; Disease Models, Animal; Dogs; Dose-Response Relationship, Drug; Erythromycin; Gastrointestinal Agents; Morphine; Motilin; Rabbits; Reference Values

The authors consider different mechanisms participating in progression of diarrhea in ulcerative colitis. The involvement of osmotic component was suggested in view of incomplete hydrolysis of carbohydrates by small intestinal glucoamylase under mono- and bisubstrate digestion, whereas diarrhea secretory component develops in participation of cyclic nucleotides. Motor mechanism is also present in diarrhea as evidenced by high concentrations of blood motilin and changes in intestinal evacuation and motility. Polycomponent dysbioses detected in ulcerative colitis patients may also be essential for pathogenesis of diarrhea. Determination of the leading component in each diarrhea case is thought helpful in valid choice of individual therapeutic policy.

Topics: Adolescent; Adult; Colitis, Ulcerative; Diarrhea; Digestion; Digestive System; Female; Gastrointestinal Motility; Humans; Hydrogen-Ion Concentration; Hydrolysis; Intestinal Mucosa; Male; Middle Aged; Motilin; Nucleotides, Cyclic; Rectum

Topics: Cisapride; Constipation; Diarrhea; Domperidone; Dumping Syndrome; Gastric Emptying; Gastrointestinal Motility; Humans; Intestinal Diseases; Intestinal Pseudo-Obstruction; Intestine, Small; Metoclopramide; Motilin; Parasympathomimetics; Piperidines; Serotonin Antagonists; Stomach Diseases

Motilin basal level and that after carbohydrate load were radioimmunoassayed in 26 patients with ulcerative colitis. The results were correlated with the data on motor evacuatory activity of the gastrointestinal tract and clinical manifestations of diarrhea. Basal motilin level was found elevated as against the control (99 rg/ml) in all the patients and surpassed the norm (356-1001 rg/ml) in 6. A significant elevation of motilin content was associated with reduction of the amplitude and number of rhythmic type I contractions, as well as by increased number of type III (propulsive) waves and accelerated transport of the contents via the small intestine. No compensatory rarefying of acid discharge from the stomach, that was observed in reference subjects if transport of contents was accelerated, was detectable in the patients with ulcerative colitis. This resulted in acidification of the enteral medium (pH 5.6 +/- 0.6). Concomitant pancreatitis in 22 patients with reduced production of HCO3- and impaired cavitary hydrolysis of polymer substrate enhanced enteral medium acidification and changed its osmotic pressure. Specific features of enteral medium homeostasis disorders and of impairments of the gastrointestinal tract motor evacuatory function should be borne in mind when planning treatment strategy for diarrhea patients.

Topics: Adult; Colitis, Ulcerative; Diarrhea; Duodenum; Female; Gastrointestinal Transit; Humans; Hydrogen-Ion Concentration; Jejunum; Male; Middle Aged; Motilin; Time Factors

Topics: Adolescent; Child; Child, Preschool; Colitis, Ulcerative; Crohn Disease; Diabetes Mellitus; Diarrhea; Humans; Infant; Infant, Newborn; Kidney Failure, Chronic; Motilin; Radioimmunoassay; Reference Values

The normal pattern of fasting motility in the small intestine shows migrating bursts of intense electrical activity associated with smooth muscle contractions. The migrating motor complex (MMC) is a recurring pattern of contractions of the human small bowel which is inhibited in the fed state. At any given site the entire MMC cycle comprises three phases numbered 1, 2 and 3. Phase 3 activity, the most prominent feature of the MMC, consists of a burst of intense contractions which generally start in the stomach or in the duodenum and migrate distally. In humans, phase 3 recurs every 110 minutes and clears the small bowel of cellular debris and residual food. During phase 2, several other patterns of motility have been identified in man. The migrating action potential complex (MAPC) or its manometric equivalent (peristaltic rush) is an infrequent event in normal subjects, occurring only once every 160 minutes. Minute rhythms are defined as rhythmic bursts of phasic contractions of shorter duration than phase 3 and occurring with a much greater periodicity. They never occur in fed state. At night, the periodicity of phase 3 is more regular and its propagation velocity is slower than during daytime. In normal subjects the MMC pattern shows important inter- and intra-individual variations which need to be known to study patients with disorders of small bowel motility.

Topics: Animals; Circadian Rhythm; Diarrhea; Dogs; Electromyography; Fasting; Gastrointestinal Motility; Humans; Intestine, Small; Manometry; Motilin; Muscle Contraction; Muscle, Smooth

Motilin, normally present in a specific cell type in the upper small intestine, is believed to have a physiologic role in initiating the interdigestive migrating motor complex. Motilin may play a pathophysiologic role in the diarrhea in the irritable bowel syndrome, the dumping syndrome, chronic liver disease, and chronic renal failure. Furthermore, increased frequency of bowel movements is an important symptom in patients with the carcinoid syndrome. We have studied 73 patients with metastatic carcinoid tumors with regard to stool frequency and plasma concentration of motilin and neuropeptide K (NPK) and diurnal urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA). Thirty-eight (52%) of the 73 patients had elevated (greater than 126 pmol/l) plasma concentrations of motilin, whereas 59 (81%) of the patients had diarrhea. The increased frequency of bowel motions correlated significantly (p less than 0.01) with the plasma concentrations of motilin, whereas no significant correlation with 5-HIAA and NPK was found. High-performance liquid chromatography of plasma extracts showed a single component eluting in the position of synthetic porcine motilin. However, extracts from five carcinoid tumors did not contain any significant levels of motilin. Carcinoid tumors are known to contain and secrete several biologically active substances such as serotonin, histamine, prostaglandins, and tachykinins, which are likely to cause disturbances of intestinal secretion and motility, which in turn might release motilin from the motilin-containing cells of the small intestine. The increased motilin levels might then participate in a vicious diarrhea circle together with the other agents.

Topics: Carcinoid Tumor; Chromatography, High Pressure Liquid; Diarrhea; Female; Gastrointestinal Motility; Humans; Hydroxyindoleacetic Acid; Male; Motilin; Neuropeptides; Radioimmunoassay; Tachykinins

Topics: Acidosis; Adenoma, Islet Cell; Aged; Diarrhea; Drug Resistance; Female; Humans; Hypokalemia; Injections, Subcutaneous; Kidney Failure, Chronic; Male; Motilin; Neurotensin; Octreotide; Pancreatic Neoplasms; Pancreatic Polypeptide; Somatostatin; Vasoactive Intestinal Peptide

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

Cyclic pattern of interdigestive motility and of plasma levels of motilin, somatostatin and pancreatic peptide (PP) show close relationship. During interdigestive state gastric and lower esophageal motility seems to be mediated by pulsatile release of motilin, whereas the motor activity of duodenum seems to be controlled by somatostatin. Disturbed interdigestive motility could be demonstrated in gastrointestinal diseases like bacterial overgrowth, sclerodermia, post-vagotomy diarrhea and reflux esophagitis.

Topics: Diarrhea; Female; Gastroesophageal Reflux; Gastrointestinal Motility; Humans; Intestinal Obstruction; Intestinal Secretions; Male; Motilin; Peptides; Scleroderma, Systemic; Somatostatin; Vagotomy

The gut hormone response to a breakfast meal was studied in 12 subjects hospitalised for an episode of acute diarrhoea (presumed infective) who were otherwise well and in 13 healthy control subjects. Fasting blood glucose concentrations were low but basal insulin concentrations were raised. Basal concentrations of pancreatic polypeptide and both basal and postprandial responses of motilin, enteroglucagon, and vasoactive intestinal polypeptide (VIP) were also significantly greater than controls. No abnormalities in plasma concentrations of gastrin, gastric inhibitory polypeptide (GIP) or pancreatic glucagon were found. The suggested physiological actions of the raised hormones may be relevant to the pathophysiology of diarrhoea.

Topics: Acute Disease; Adult; Aged; Blood Glucose; Diarrhea; Female; Food; Gastrointestinal Hormones; Glucagon-Like Peptides; Humans; Insulin; Male; Middle Aged; Motilin; Pancreatic Polypeptide; Vasoactive Intestinal Peptide

A number of human diseases with intestinal adaptation have been investigated, including acute infective diarrhoea, intestinal resection, jejuno-ileal bypass, coeliac disease, tropical sprue, chronic pancreatitis and cystic fibrosis. In all, the newly isolated hormone enteroglucagon appeared to be elevated in proportion to the degree of adaptation. In rats after gut resection and cold adaptation, enteroglucagon was also elevated and the degree of elevation correlated closely with the crypt cell production rate (CCPR). Chronic administration of somatostatin suppressed both enteroglucagon and CCPR, while bombesin stimulated both. A crude preparation of enteroglucagon was found to directly stimulate DNA synthesis in enterocyte cultures. It is thus concluded that, at present, the most likely candidate for the humoral component of intestinal adaptation is the hormonal peptide enteroglucagon.

Topics: Adaptation, Physiological; Adult; Animals; Cattle; Diarrhea; Gastrointestinal Hormones; Glucagon-Like Peptides; Humans; Hypertrophy; Infant; Inflammation; Intestinal Diseases; Intestinal Mucosa; Intestine, Small; Intestines; Mice; Motilin; Obesity; Rats

Topics: Diarrhea; Esophagus; Gastric Emptying; Gastrointestinal Hormones; Humans; Motilin

Topics: Animals; Chemical Phenomena; Chemistry; Diarrhea; Digestive System; Dogs; Electrophysiology; Gastrointestinal Hormones; Gastrointestinal Motility; Humans; Motilin; Radioimmunoassay