Effect of intragastric or intraduodenal administration of a polymeric diet on gallbladder motility, small-bowel transit time, and hormone release.
OBJECTIVE
During postpyloric tube feeding, GI intolerance is observed more frequently than during prepyloric feeding, possibly by evoking a stronger GI response.


METHODS
We investigated the effect of intragastric and intraduodenal administration of a polymeric diet (125 kcal/h) on gallbladder motility (by ultrasonography), duodeno-cecal transit time (by lactulose H2 breath test), and GI hormone release (including cholecystokinin, pancreatic polypeptide, and gastrin). Six healthy subjects (two male, four female; mean age 22 yr, range 18-27 yr) were studied on two separate occasions in random order during 6 h of continuous administration of the diet through either the gastric or duodenal port of a two-lumen tube.


RESULTS
Intraduodenal feeding resulted in a more rapid contraction of the gallbladder, from 32 +/- 4 to 23 +/- 4 cm3 at 10 min (p < 0.05), reaching a minimum of 6 +/- 1 cm3, in contrast to intragastric feeding (31 +/- 4 to 19 +/- 3 cm3 at 60 min, p < 0.05; minimum 14 +/- 1 cm3). The gallbladder remained contracted during the 6-h study period during both intraduodenal and intragastric feeding. Small-bowel transit time was significantly accelerated during intraduodenal compared with intragastric feeding (51 +/- 12 vs 81 +/- 9 min; p = 0.003). Plasma cholecystokinin secretion was significantly (p < 0.05) increased during intraduodenal compared with intragastric feeding (848 +/- 107 vs 279 +/- 89 pmol x L(-1) x 360 min). The same was true for pancreatic polypeptide secretion. However, gastrin release was significantly (p < 0.05) higher during intragastric feeding.


CONCLUSIONS
Intraduodenal feeding elicited a stronger GI response than intragastric feeding, as demonstrated by accelerated small-bowel transit time, more rapid and stronger gallbladder contractions, and increased cholecystokinin and pancreatic polypeptide release. Gastrin release, on the other hand, was stronger during intragastric feeding.
Ledeboer
M
M
Department of Gastroenterology-Hepatology, Leiden University Medical Center, The Netherlands.
Masclee
A A
AA
Biemond
I
I
Lamers
C B
CB
D000293:Adolescent; D000328:Adult; D002432:Cecum / Q000502:physiology; D002766:Cholecystokinin / Q000378:metabolism*; D004386:Duodenum / Q000502:physiology; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005704:Gallbladder / Q000502:physiology*; D005755:Gastrins / Q000378:metabolism*; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D008297:Male; D010191:Pancreatic Polypeptide / Q000378:metabolism*
D005755:Gastrins; D010191:Pancreatic Polypeptide; D002766:Cholecystokinin