title: The osmotic laxative magnesium sulphate activates the ileal brake.
abstract: BACKGROUND
  Alterations in gastrointestinal motility and hormone secretion, especially activation of the ileal brake, have been documented in malabsorption.
  
  
  OBJECTIVE
  To investigate whether artificially-induced accelerated small intestinal transit activates the ileal brake mechanism.
  
  
  METHODS
  Eight healthy volunteers (four female, four male; age 21 +/- 3 years) participated in four experiments: (a) meal with either oral magnesium sulphate (MgSO4) or placebo; and (b) fasting with either oral MgSO4 or placebo. Antroduodenal motility was recorded by perfusion manometry. Duodenocaecal transit time was determined by the lactulose H2 breath test. Gall-bladder volume was measured by ultrasound at regular intervals, and blood samples were drawn for determination of cholecystokinin and peptide YY (RIA). Twenty-four hour faecal weight and fat excretion were determined.
  
  
  RESULTS
  MgS04 significantly accelerated duodenocaecal transit time and increased faecal fat and weight in all subjects. MgSO4 significantly delayed the reoccurrence of phase III and affected antroduodenal motility during fasting but not after meal ingestion. Postprandial gall-bladder relaxation and postprandial peptide YY release were significantly increased during the MgSO4 experiment compared to placebo.
  
  
  CONCLUSIONS
  The osmotic laxative MgS04 accelerates intestinal transit both in the fasting and fed state. MgS04 activates the ileal brake mechanism only in the fed state, with peptide YY release and inhibition of gall-bladder emptying.
authors.affiliation: Department of Gastroenterology-Hepatology, Leiden University Medical Centre, The Netherlands.
authors.forename: M K
authors.initials: MK
authors.lastname: Vu
authors.forename: M A
authors.initials: MA
authors.lastname: Nouwens
authors.forename: I
authors.initials: I
authors.lastname: Biemond
authors.forename: C B
authors.initials: CB
authors.lastname: Lamers
authors.forename: A A
authors.initials: AA
authors.lastname: Masclee
mesh_terms: D000293:Adolescent; D000328:Adult; D001944:Breath Tests; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D005215:Fasting; D005243:Feces / Q000737:chemistry; D005260:Female; D005704:Gallbladder / Q000033:anatomy & histology / Q000187:drug effects / Q000502:physiology; D005769:Gastrointestinal Motility / Q000187:drug effects*; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D007082:Ileum / Q000187:drug effects / Q000502:physiology*; D008278:Magnesium Sulfate / Q000494:pharmacology*; D008297:Male
chemical_list: D002121:Calcium Channel Blockers; D008278:Magnesium Sulfate; D006859:Hydrogen