OBJECTIVE: To investigate the effect of gastric antrum ultrasonography in evaluating gastric emptying after oral administration of 300 mL carbohydrates two hours before cesarean section, and to analyze the risk factors of gastric emptying in pregnant women. METHODS: From August 2020 to February 2021, a total of 80 patients, aged 22-43 years, body mass index (BMI) < 35 kg/m², gestational age≥36 weeks, falling into American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, scheduled for cesarean sections in Peking University International Hospital were recruited and divided into two groups: the intervention group (n=40)and the control group (n=40). In the intervention group, solid food was restricted after 22:00, the patients were required to take 300 mL carbohydrates two hours before cesarean section. In the control group, solid food and liquid intake were restricted after 22:00 the night before surgery. All the patients received assessment of preoperative feeling of thirst and starvation with visual analogue scale (VAS). The cross-sectional area (CSA)of gastric antrum was measured in supine position and right supine position before anesthesia, the gastric volume (GV)and the gastric volume/weight(GV/W)of the two groups was further calculated. Perlas A semi-quantitative grading assessments were performed in each patient. The blood pressure and heart rate were recorded at admission(T0), 5 minutes after anesthesia (T1), immediately after fetal delivery (T2) and at the end of the surgery (T3). The occurrence of nausea and vomiting during the operation and 24 hours after the operation were recorded. RESULTS: One case in each group was excluded because the antrum was not clearly identified during the ultrasound assessments. In the semi-sitting position, the CSA was (5.07±1.73) cm² in the intervention group vs. (5.24±1.96) cm² in the control group, respectively; in the right lateral decubitus position, CSA was (7.32±2.17) cm² in the intervention group vs. (7.25±2.24) cm² in the control group, GV was (91.74±32.34) mL vs. (90.07±31.68) mL, GV/W was (1.27±0.40) mL/kg vs. (1.22±0.41) mL/kg, respectively; all the above showed no significant difference between the two groups (P > 0.05). Perlas A semi-quantitative grading showed 0 in 20 patients (51.3%), 1 in 16 (41%), 2 in 3 (7.7%)in the intervention group and 0 in 22 (56.4%), 1 in 15 (38.5%), 2 in 2 (5.1%)in the control group, the proportion of Perlas A semi-quantitative grading showed no significant difference between the two groups (P > 0.05). For the patients with Perlas A semi-quantitative grade 2 (3 cases in the intervention group and 2 cases in the control group), metoclopramide 0.2 mg/kg was intravenously injected before anesthesia. No aspiration case was observed in this study. The intervention group was endured less thirst and hunger (P < 0.05). There was no significant difference in blood pressure and heart rate between the two groups at each time point (P > 0.05). There was no significant difference in the incidence of intraoperative hypotension between the two groups (P > 0.05). There was no significant difference in the incidence of nausea intraoperatively and postoperatively between the two groups (P > 0.05). CONCLUSION Ultrasonography of gastric antrum can provide objective basis for evaluating gastric emptying of pregnant women perioperatively. 300 mL carbohydrates intake two hours before surgery, which does not increase GV and the risk of reflux aspiration, and is helpful in minimizing disturbance to the patient's physiological status, therefore leading to better clinical outcome.
Humans ; Female ; Pregnancy ; Gastric Emptying/physiology* ; Cesarean Section ; Prospective Studies ; Ultrasonography ; Carbohydrates ; Nausea

Assessment of transit through the gastrointestinal tract provides useful information regarding gut physiology and pathophysiology. Although several methods are available, each has distinct advantages and limitations. Recently, an ingestible wireless motility capsule (WMC), similar to capsule video endoscopy, has become available that offers a less-invasive, standardized, radiation-free and office-based test. The capsule has 3 sensors for measurement of pH, pressure and temperature, and collectively the information provided by these sensors is used to measure gastric emptying time, small bowel transit time, colonic transit time and whole gut transit time. Current approved indications for the test include the evaluation of gastric emptying in gastroparesis, colonic transit in constipation and evaluation of generalised dysmotility. Rare capsule retention and malfunction are known limitations and some patients may experience difficulty with swallowing the capsule. The use of WMC has been validated for the assessment of gastrointestinal transit. The normal range for transit time includes the following: gastric emptying (2-5 hours), small bowel transit (2-6 hours), colonic transit (10-59 hours) and whole gut transit (10-73 hours). Besides avoiding the use of multiple endoscopic, radiologic and functional gastrointestinal tests, WMC can provide new diagnoses, leads to a change in management decision and help to direct further focused work-ups in patients with suspected disordered motility. In conclusion, WMC represents a significant advance in the assessment of segmental and whole gut transit and motility, and could prove to be an indispensable diagnostic tool for gastrointestinal physicians worldwide.
Colon ; Constipation ; Deglutition ; Diagnosis ; Endoscopy ; Gastric Emptying ; Gastrointestinal Motility ; Gastrointestinal Tract ; Gastrointestinal Transit ; Gastroparesis ; Humans ; Hydrogen-Ion Concentration ; Physiology ; Reference Values

This paper presents a removal method of electrogastrogram (EGG) baseline wander based on wavelet transformation. The basic idea of this method is using the low-frequency signal which is obtained through multi-scale decomposition of EGG signals to approximate the baseline wander of EGG, so the component of baseline wander is filtered out from the sampling EGG signals. The method was applied successfully to process the experimental data of dog EGG in our laboratory. The experimental data and analysis of results showed that this method could filter out the baseline wander of EGG, and this method would not affect the gastric spike and slow wave bandwidth signals, which could be shown from the characteristics of bandwidth filter of wavelet transformation.
Algorithms ; Animals ; Artifacts ; Dogs ; Electrodiagnosis ; Electrophysiological Phenomena ; Gastric Emptying ; physiology ; Gastrointestinal Motility ; physiology ; Myoelectric Complex, Migrating ; physiology ; Signal Processing, Computer-Assisted ; Wavelet Analysis

The present study was to investigate the effects of diltiazem, a ghrelin receptor agonist, on food intake and gastrointestinal functions in rats. Rats were intragastrically administered with diltiazem solution (daily 16 mg/kg, 30 mg/kg or 80 mg/kg, 30 d), and the rats with saline as control. To detect the effects of diltiazem on food intake and body weight, the average daily food intake and body weight were recorded, and the serum metabolic hormones of plasma growth hormone (GH) and neuropeptide Y (NPY) were tested by radioimmunoassay. By means of the spectrophotometer and the modified Mett's method, the effects of diltiazem on rat's gastrointestinal function and pepsin activity were tested, respectively. In addition, the gastric juice's acidity of rats was detected by titration and the secretion amount was calculated. The results showed that the food intake and body weight were maximally promoted by diltiazem at the dose of 30 mg/kg daily (30 d). The average daily food intake and body weight were significantly increased, and the serum concentrations of GH and NPY were also remarkably increased in diltiazem-treated groups compared with those in control group. The results also showed that the gastric emptying rate, gastric acid secretion and the activity of pepsin were significantly increased in diltiazem-treated group compared with those in control group. These results suggest that diltiazem induces enhancement of eating, in the same time, it can also stimulate the gastrointestinal function and regulate growth of rat.
Animals ; Body Weight ; drug effects ; Diltiazem ; pharmacology ; Eating ; drug effects ; Female ; Gastric Emptying ; drug effects ; Gastrointestinal Motility ; drug effects ; Gastrointestinal Tract ; physiology ; Growth Hormone ; blood ; Neuropeptide Y ; blood ; Rats ; Rats, Sprague-Dawley ; Receptors, Ghrelin ; agonists

OBJECTIVETo evaluate nutritional status, myoelectrical activity, and gastrointestinal tract emptying capacity after integral continuous jejunal interposition following subtotal gastrectomy.

METHODSAccording to different re-construction techniques, 30 Beagle dogs were divided into four groups after subtotal distal gastrectomy: group 1(n=9, integral continuous jejunal interposition), group 2(n=6, Billroth I(), group 3(n=7, Billroth II(), group 4(n=8, isolated jejunal interposition). Blood cell counts, liver function, myoelectrical activity and the rate of gastrointestinal tract emptying were compared among the four groups.

RESULTSAt week 12 after operation, the body weight in group 1 [(9.65±1.54) kg] was significantly higher than that in group 2[(9.25±1.76)kg], group 3[(9.31±1.54)kg] and group 4[(7.77±1.46)kg]. At week 4, the prognostic nutritional index in group 1(2671.9±49.9) was significantly higher than that in group 3(2555.9±54.7) and group 4(2440.9±54.3), but similar to that in group 2(2791.8±54.3). At week 6, the fasting and postprandial frequency of jejunal pacesetter potentials in group 1 were higher than those in group 3 and group 4(P<0.05) but comparable with those in group 2. The emptying rate of food in the four groups were 95.4%, 91.3%, 93.1% and 94.2%, respectively and there were no significant differences(P>0.05). However, as compared with group 2 and group 3, group 1 had longer operative time and later regular diet resumption, more severe abdominal adhesion(P<0.05).

CONCLUSIONContinuous jejunal interposition should be considered when Billroth I( is not feasible after subtotal gastrectomy.

Anastomosis, Surgical ; methods ; Animals ; Digestive System Surgical Procedures ; methods ; Dogs ; Female ; Gastrectomy ; methods ; Gastric Emptying ; physiology ; Gastroenterostomy ; Male ; Myoelectric Complex, Migrating ; physiology ; Nutritional Status ; Postoperative Period

OBJECTIVETo explore the impact of abnormal myoelectricity at gastroduodenal anastomosis on gastric emptying in rats.

METHODSRats were randomly divided into experimental group (n=16) and control group (n=16). Pylorectomy and end-to-end gastroduodenal anastomosis were performed in the experimental group and electrodes were implanted in the serosal surface adjacent to the anastomosis. Slow waves were recorded by the implanted electrode in vivo. Gastric emptying was examined by scintigraphy.

RESULTSAt the first week after surgery, antral slow-wave frequency was significantly lower in the experimental group (0.8±1.4 vs. 3.3±1.2, P<0.01), as was the duodenal slow-wave frequency (2.1±0.6 vs. 11.1±0.7, P<0.01). There was no consecutive slow-waves transduction across the pylorus or the anastomosis. Within 12-16 weeks after operation, antral slow-wave frequency in the experimental group and the control group were (8.7±0.6) cpm and (4.0±0.4) cpm, respectively (P<0.01), and duodenal slow-wave frequency were (11.1±0.8) cpm and (10.8±0.7) cpm, respectively (P>0.05). Retrograde and antegrade myoelectricity transduction through the anastomosis were detected. The mean semi-emptying time in the proximal stomach was 14.7 min in the experimental group and 13.6 min in the control group (P>0.05). Radionuclide retention rate was 25.4% in the experimental group and 39.4% in the control group (P>0.05). The mean semi-emptying time in the distal stomach was 25.3 min in the experimental group and 10.5 min in the control group (P<0.01). Radionuclide retention rate was 46.4% in the experimental group and 18.7% in the control group (P<0.01).

CONCLUSIONThe abnormal myoelectricity in the region of gastroduodenal stoma may delay liquid gastric emptying in pylorectomy rats.

Animals ; Duodenum ; physiology ; surgery ; Gastric Emptying ; physiology ; Gastroenterostomy ; Male ; Myoelectric Complex, Migrating ; physiology ; Rats ; Rats, Sprague-Dawley ; Surgical Stomas ; physiology

OBJECTIVETo investigate the effect and mechanism of ghrelin and its synthetic peptide GHRP-6 on gastric motor in mice.

METHODSIn vivo, the dose-dependent effects of ghrelin (20,50,100,200 mug/kg) and GHRP-6 (20,50,100,200 mug/kg) on gastric emptying were measured by intragastric application of phenol red test which was adapted for use in mice. The effects of atropine, NG-nitro-L-arginine methyl ester (L-NAME), and D-Lys(3)-GHRP-6 (GHS-R antagonist) on the gastric motor induced by ghrelin and GHRP-6 (100 mug/kg) were also investigated. In vitro, the effects of ghrelin (0.01,0.1,1.0,10.0 mumol/L) and GHRP-6 (0.01,0.1,1.0,10.0 mumol/L) on spontaneous contraction of mice fundic muscle strips were studied as well.

RESULTSBoth ghrelin (50,100,200 mug/kg) and GHRP-6 (50,100,200 mug/kg) significantly accelerated gastric emptying (P<0.05), but they failed to accelerate gastric emptying in the presence of atropine, L-NAME and D-Lys(3)-GHRP-6 (P<0.05). Ghrelin (0.1, 1.0, 10.0 mumol/L) and GHRP-6 (0.1, 1.0, 10.0 mumol/L) induced significant contraction of fundic muscle strips in concentration-dependent manner (P<0.05), which could be blocked by tetrodotoxin.

CONCLUSIONGhrelin and its synthetic peptide GHRP-6 accelerate gastric emptying perhaps by activating GHS-R of cholinergic excitatory pathways and nitrergic nervous pathways in the enteric nervous system.

Animals ; Female ; Gastric Emptying ; drug effects ; Ghrelin ; pharmacology ; Male ; Mice ; Mice, Inbred C57BL ; Oligopeptides ; pharmacology ; Stomach ; drug effects ; physiology

This paper introduces a 4-electrode gastric-emptying measurement system using an electrical bio-impedance method by which gastric-emptying experiments of 24 healthy volunteers have been carried out. The test results show that the base impedance is stable, the average GET/2 is 8.78 +/- 1.76 min. The new system provides a new non-invasive measurement method for the clinical study on gastric-emptying functions.
Eating ; physiology ; Electric Impedance ; Gastric Emptying ; physiology ; Humans

OBJECTIVETo study the effect of stigma maydis polysaccharide (SMPS) on gastrointestinal movement.

METHODTaking charcoal as the indicator and taking ratio of charcoal movement, beginning time of black excretion and stool amount as the index to observe the effect of SMPS on intestinal movement in mice. Taking emthylorange as the indicator and taking the ratio of residual rate of methylorange as the index to observe the effect of SMPS on gastric emptying in mice. Taking methylene blue as the indicator and taking the time of gastric emptying and movement speed of intestinal content as the index to observe the effect of SMPS on gastrointestinal movement in rats. Observing the changes of cholecystokinin (CCK) level in plasm in rats.

RESULTCompared with control, the ratio of charcoal movement increased in mice (P <0.01). The beginning time of black excretion shortened and the stool amount increased in mice (P <0.01). The ratio of residual rate of methylorange increased in mice (P <0. 01). The time of gastric emptying prolonged in rats (P <0.01). The movement speed of intestinal content in rats accelerated (P <0.01). CCK level in plasm increased in rats (P < 0.05).

CONCLUSIONEffects of stigma maydis polysaccharide on gastrointestinal movement are probably related to the increasing of CCK level in plasm.

Animals ; Cholecystokinin ; blood ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Gastric Emptying ; drug effects ; Gastrointestinal Agents ; isolation & purification ; pharmacology ; Gastrointestinal Motility ; drug effects ; Intestine, Small ; physiology ; Male ; Mice ; Plants, Medicinal ; chemistry ; Polysaccharides ; isolation & purification ; pharmacology ; Random Allocation ; Rats ; Rats, Wistar ; Zea mays ; chemistry

OBJECTIVETo study the primary effects of Niuhuang Qingwei wan on the gastrointestinal function in aninmal for justifying its efficacies in clinic.

METHODMice were twice administered with Niuhuang Qingwei wan (0.83, 1.67, 3.33 g x kg(-1), ig) and rats were twice administered with Niuhuang Qingwei wan (0.59, 1.18, 2.36 g x kg(-1), ig). The effects on the stomach function were evaluated by the gastric emptying test in mice and the gastric analysis in rats. The effect on the intestinal function were evaluated by the propulsive motility of the total gastrointestinal tract test in mice by recording the time and frequency of excreting carbo medicinalis. Its analgesia was explored by using the abdominal constriction test induced by acetic acid.

RESULTNiuhuang Qingwei wan decreased the activity and secretion of pepsin in a dose-dependent manner (P < 0.01, P < 0.05), the gastric juice volume at middle and high doses (P <0.01, P <0.05), and the gastric acid volume at high dose (P <0.05); However, it had no significant effects on the gastric emptying in normal mice and the acidity in gastric juice. It shortened the excreting time of feces and increased the frequency of defecation (P < 0.01, P < 0.05). It also inhibited abdominal constriction responses at high dose, and the inhibition rate was 40.0% (P <0.01).

CONCLUSIONNiuhuang Qingwei wan can promote gastrointestinal motility, decrease gastric acid volume and activity of pepsin and show certain analgesia effect. Those findings are consistent with its treating stomach heat in clinic.

Animals ; Defecation ; drug effects ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Gastric Acid ; metabolism ; Gastric Emptying ; drug effects ; Gastric Juice ; metabolism ; Gastrointestinal Motility ; drug effects ; Male ; Medicine, Chinese Traditional ; Mice ; Mice, Inbred ICR ; Pepsin A ; secretion ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stomach ; drug effects ; metabolism ; physiology