Assessment of gastric emptying using a low fat meal: Establishment of international control values

Knowledge of the disintegration of solid foods in human stomach is essential to assess the bioavailability of nutrients in the gastrointestinal (GI) tract. A comprehensive review of food gastric digestion, focusing on disintegration of solid foods, is presented. Most of the research reviewed in this paper is contained in the medical, pharmaceutical, food, and nutritional literature. Stomach physiology is briefly introduced, including composition and rheological properties of gastric contents, stomach wall motility in fed/fasted states, and hydrodynamic and mechanical forces that act on the ingested food. In vivo and in vitro methods used for studying food and drug digestion in GI are summarized. Stomach emptying rate, which controls the rate of absorption of nutrients, is highly related to the disintegration of foods. This topic is highlighted with focus on the important mechanisms and the influence of chemical and physical properties of foods. Future research in this area is identified to increase our fundamental understanding of the food digestion process in the stomach as related to the food composition, material properties such as texture and microstructure, and chemical characteristics. This information is necessary to develop new guidelines for seeking innovative processing methods to manufacture foods specifically targeted for health.

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Disintegration of Solid Foods in Human Stomach

The oesophagus extends from the pharynx at the level of the sixth cervical vertebra to the stomach at the level of T10. It lies in close relation to the aorta from T3 downwards and is behind the heart in the anterior/posterior plane from T5 to T10. It is lined by squamous epithelium.

The Gastrointestinal Tract

https://www.gastrojournal.org/article/S0016-5085(01)70567-7/pdf

Glucagon-like peptide 2 improves nutrient absorption and nutritional status in short-bowel patients with no colon

Background: The enhanced vulnerability of women to develop alcohol-related diseases may be due to their higher blood alcohol levels after drinking, but the mechanism for this effect is debated.

Methods: Sixty-five healthy volunteers of both genders drank 0.3 g of ethanol/kg of body weight (as 5%, 10%, or 40% solutions) postprandially. Blood alcohol concentrations were monitored by breath analysis and compared with those after intravenous infusion of the same dose. First-pass metabolism was quantified (using Michaelis-Menten kinetics) as the route-dependent difference in the amount of ethanol reaching the systemic blood. Gastric emptying was assessed by nuclear scanning after intake of 300 μCurie of technetium-labeled diethylene triamine pentacetic acid in 10% ethanol. The activities of alcohol dehydrogenase isozymes were assessed in 58 gastric biopsies, using preferred substrates for γ-ADH (acetaldehyde) and for ς-ADH (m-nitrobenzaldehyde) and a specific reaction of χ-ADH (glutathione-dependent formaldehyde dehydrogenase).

Results: Women had less first-pass metabolism than men when given 10% or 40%, but not 5%, alcohol. This was associated with lower gastric χ-ADH activity; its low affinity for ethanol could explain the greater gender difference in first-pass metabolism with high rather than with low concentrations of imbibed alcohol. Alcohol gastric emptying was 42% slower and hepatic oxidation was 10% higher in women. A 7.3% smaller volume of alcohol distribution contributed to the higher ethanol levels in women, but it did not account for the route-dependent effects.

Conclusions: The gender difference in alcohol levels is due mainly to a smaller gastric metabolism in females (because of a significantly lesser activity of χ-ADH), rather than to differences in gastric emptying or in hepatic oxidation of ethanol. The concentration-dependency of these effects may explain earlier discrepancies. The combined pharmacokinetic differences may increase the vulnerability of women to the effects of ethanol.

Gender differences in pharmacokinetics of alcohol.

Scintigraphic evaluation of gastric emptying.

In this study, gallbladder and gastric emptying were compared in 15 normal subjects and 15 patients with gallstones. A noninvasive technique which uses two gamma-emitting radiopharmaceutical agents to image the gallbladder and stomach simultaneously was employed. Technetium-99m-HIDA was used as a gamma-emitting marker for the gallbladder and indium-111-DTPA was mixed with a standard liquid meal in order to stimulate gallbladder emptying and to measure gastric emptying. In patients with gallstones, gallbladder emptying was diminished significantly compared to normal subjects. In contrast, emptying of the stomach was normal. The gallbladder emptying responses to octapeptide of cholecystokinin, administered either as bolus or infusion doses, were similar in normal subjects and patients with gallstones. These studies suggest that gallbladder emptying may be abnormal in patients with gallstones. The explanation for this abnormality and its relationship to the development of gallstones has not been determined.

Abnormal gallbladder emptying in patients with gallstones.

https://www.gastrojournal.org/article/0016-5085(85)90564-5/pdf

Cholinergic effects on gallbladder emptying in humans

https://www.gastrojournal.org/article/0016-5085(86)90252-0/pdf

Gallbladder emptying response to sham feeding in humans

https://www.gastrojournal.org/article/0016-5085(87)90961-9/pdf

Elizabeth Rock

Papers

Scintigraphic evaluation of gastric emptying.

Abnormal gallbladder emptying in patients with gallstones.

Cholinergic effects on gallbladder emptying in humans

Gallbladder emptying response to sham feeding in humans

Effects of Somatostatin on Gallbladder Emptying