Modulation of gastric accommodation by duodenal nutrients.
OBJECTIVE
To determine the relative potency and contribution of intestinal nutrients to net gastric accommodative relaxation and conscious perception.


METHODS
In 12 healthy subjects, we randomly tested duodenal loads of lipids and carbohydrates (12 mL administered in 4 min) at various caloric concentrations (0.0125-0.8 kcal/mL) separated by 12-24 min wash-out periods of saline infusion. Maximal gastric relaxation was induced at the end of each experiment by i.v glucagon (5 microg/kg), as reference. The reflex gastric response was measured by a barostat, and symptom perception by a 0-6 score questionnaire.


RESULTS
Lipids induced a dose-response gastric relaxation with a steep and early rise. Maximal effect (179+/-42 mL relaxation) reached at a relatively low concentration (0.2 kcal/mL), maximal lipid-induced relaxation was 61+/-6% of the glucagon effect. By contrast, duodenal infusion of carbohydrates induced weaker relaxation that became significant only at the high end of the physiological concentration range (65+/-14 mL with 0.8 kcal/mL). Intestinal nutrient loads, either of lipid or carbohydrates, did not induce significant changes in perception (0.6+/-0.4 and 0.1+/-0.4 score increase for the highest concentrations, respectively).


CONCLUSIONS
Chyme entering the small bowel induces nutrient-specific gastric relaxatory reflexes by a physiologically saturable mechanism. Normally, neither the intestinal nutrient load nor the gastric accommodative response is perceived.
Carrasco
Mauricio
M
Digestive System Research Unit, Hospital General Vall d'Hebron, Barcelona 08035, Spain.
Azpiroz
Fernando
F
Malagelada
Juan-R
JR
D000328:Adult; D004386:Duodenum / Q000502:physiology*; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D009126:Muscle Relaxation / Q000502:physiology*; D009130:Muscle, Smooth / Q000502:physiology*; D013270:Stomach / Q000502:physiology*