Steadman C, Kerlin P
Gastroenterology Department, Princess Alexandra Hospital, Brisbane, Australia.
Gut. 1994 May;35(5):641-5. doi: 10.1136/gut.35.5.641.
The motor patterns and luminal capacity of the human intestine should affect symptoms and resorption during pathological, massive small intestinal flow. Little is known of human intestinal motility in this situation. This study aimed at mimicking secretory diarrhoea (experimentally) in healthy volunteers by intrajejunal infusion of a non-absorbable iso-osmotic solution at 20 ml/min. During the infusion intraluminal jejunal pressures and small intestinal transit times were measured. The infusion initially caused jejunal contractile activity similar to that of the fed state but this was replaced by discrete clusters of contractions (DCCs) after 29.1 ((SEM) 8.2) minutes. DCCs each lasted 38 ((SEM) 0.8 seconds) and were associated with colicky abdominal discomfort. Later, after 1400-1800 ml had been infused, distal jejunal pressure waves fell to 10 mm Hg or less. Frequent fasting DCCs predicted earlier onset and more frequent DCCs during the infusion. Thus, the rate and volume of flow during simulated secretory diarrhoea determine the pattern of the small bowel pressure profile; eventually, a volume load is reached in which the small bowel acts as a poorly segmenting conduit resulting in very fast transit rates.
在病理性大量小肠液流期间，人类肠道的运动模式和管腔容量应会影响症状和吸收情况。目前对这种情况下人类肠道的蠕动知之甚少。本研究旨在通过以20毫升/分钟的速度向健康志愿者空肠内输注不可吸收的等渗溶液，在实验中模拟分泌性腹泻。在输注过程中，测量空肠腔内压力和小肠通过时间。输注开始时引起的空肠收缩活动类似于进食状态，但在29.1（标准误8.2）分钟后被离散的收缩簇（DCCs）所取代。每个DCC持续38（标准误0.8秒），并伴有绞痛性腹部不适。后来，在输注1400 - 1800毫升后，空肠远端压力波降至10毫米汞柱或更低。空腹时频繁出现的DCCs预示着输注期间更早出现且更频繁的DCCs。因此，模拟分泌性腹泻期间的流速和流量决定了小肠压力分布模式；最终，会达到一个容量负荷，此时小肠作为一个分段不良的管道，导致非常快的通过速度。
