Coremans G, Geypens B, Vos R, Tack J, Margaritis V, Ghoos Y, Janssens J
Department of Gastroenterology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium.
Neurogastroenterol Motil. 2004 Feb;16(1):107-11. doi: 10.1046/j.1365-2982.2003.00463.x.
Patients with slow transit constipation frequently have delayed gastric emptying. In animals rectal distensions inhibit gastrointestinal motility. In healthy volunteers isovolumetric rectal distensions delay upper gut transit. The purpose of this study was to determine the effect of continuous isobaric rectal distension on gastric emptying and oro-cecal transit in young females. Using validated 13C octanoic and lactose-[13C] ureide breath tests gastric half-emptying time and oro-cecal transit time for a meal were measured in 12 volunteers. The tests were repeated in randomized order: during isobaric balloon distension and during sham distension. Isobaric rectal distension was applied using a polyethylene bag connected to a barostat. Intraballoon pressure was kept just below the threshold for the urge sensation. Mean gastric half-emptying time during rectal distension (92.3 +/-5.1 min) was significantly higher than during sham distension (78.8 +/- 4 min; P = 0.015). Mean oro-cecal transit time during rectal distension (391.3 +/-29.1 min) and sham distension (328.8 +/- 38.4 min) were not significantly different. In conclusion, these findings indicate that isobaric rectal distension inhibits gastric emptying, but not small bowel transit in young healthy women. Studies in patients with constipation are indicated.
慢传输型便秘患者常伴有胃排空延迟。在动物实验中，直肠扩张会抑制胃肠蠕动。在健康志愿者中，等容直肠扩张会延迟上消化道传输。本研究的目的是确定持续等压直肠扩张对年轻女性胃排空和口盲肠传输的影响。使用经过验证的13C辛酸和乳糖-[13C]脲呼气试验，对12名志愿者的一餐胃半排空时间和口盲肠传输时间进行了测量。测试以随机顺序重复进行：在等压球囊扩张期间和假扩张期间。使用连接到恒压器的聚乙烯袋进行等压直肠扩张。球囊内压力保持在刚好低于便意阈值的水平。直肠扩张期间的平均胃半排空时间（92.3±5.1分钟）显著高于假扩张期间（78.8±4分钟；P = 0.015）。直肠扩张期间的平均口盲肠传输时间（391.3±29.1分钟）和假扩张期间（328.8±38.4分钟）无显著差异。总之，这些发现表明，等压直肠扩张会抑制年轻健康女性的胃排空，但不会影响小肠传输。有必要对便秘患者进行研究。
