Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, Städt. Klinikum Munich-Bogenhausen, Academical Teaching Hospital of Technical University Munich, Munich, Germany.
Neurogastroenterol Motil. 2012 Aug;24(8):e373-80. doi: 10.1111/j.1365-2982.2012.01955.x. Epub 2012 Jun 20.
Knowledge about human cyclic fasting motility (MMC) and the postprandial response is mostly based on manometric findings in the upper small intestine. Hardly any data exist on human ileal motility, as the acquisition of data has been limited by methodological concerns. The aim was to study human jejunal and ileal motility in an optimized manometric setting.
Solid-state 24-h-manometry was performed in the jejunum and ileum of healthy individuals, applying a strict protocol for fasting, resting, and the consumption of a standardized meal. Both visual qualitative and validated computerized quantitative contraction and propagation analysis were performed.
MMC occurs in similar frequency in the jejunum and ileum, but it was significantly shorter in the jejunum at night. By many characteristics, ileal motility was less intense and propagative than jejunal: less migrating clustered contractions, and slower propagation velocity and shorter distance in phases II and III, and postprandially - possibly slowing and enhancing nutrient absorption. Prolonged propagated contractions in some individuals were identified as a unique ileal propulsive pattern. Postprandially, an abrupt conversion to a digestive motility pattern occurs simultaneously independent of the region.
CONCLUSIONS & INFERENCES: We found similar basic phenomena of fasting and postprandial motility in the jejunum and ileum of healthy humans. However, different calibration of propagative and contractile activity and special motor events in the ileum may account for a different physiological role in digestion. Future studies of small-bowel motility in healthy and diseased subjects focusing on segmental differences of proximal and distal intestine may be rewarded.
关于人类周期性禁食运动（MMC）和餐后反应的知识主要基于上小肠的测压学发现。关于人类回肠运动的数据几乎不存在，因为数据的获取受到方法学的限制。本研究旨在优化测压设置下研究人类空肠和回肠的运动。
在健康个体的空肠和回肠中进行固态 24 小时测压，应用严格的禁食、休息和标准化餐食摄入方案。同时进行视觉定性和经过验证的计算机定量收缩和传播分析。
MMC 在空肠和回肠中的发生频率相似，但夜间在空肠中明显更短。在许多特征上，回肠的运动强度和传播性均低于空肠：较少出现移行性簇状收缩，II 相和 III 相的传播速度和距离较慢，餐后可能会减缓并增强营养吸收。一些个体中出现的延长传播收缩被确定为独特的回肠推进模式。餐后，一种突然的消化运动模式转换同时发生，与区域无关。
我们在健康人类的空肠和回肠中发现了类似的空腹和餐后运动基本现象。然而，回肠的传播和收缩活动以及特殊运动事件的不同校准可能解释了其在消化中的不同生理作用。未来对健康和患病受试者的小肠运动进行研究，重点关注近端和远端肠道的节段差异，可能会有回报。
