title: Role of free fatty acids in regulating gastric emptying and gallbladder contraction.
abstract: The limited effectiveness of orlistat, an inhibitor of gastrointestinal lipases, in inhibiting fat digestion is not completely understood. Therefore we studied the effect of orally and duodenally administered orlistat on gastric emptying, cholecystokinin (CCK) secretion, and gallbladder contraction. In healthy males, gastric emptying of solids and fat were quantified scintigraphically, gallbladder contraction by ultrasound and CCK release by radioimmunoassay. Three studies were performed: (1) oral and (2) duodenal orlistat with a fat-containing meal, and (3) duodenal orlistat with a fat-free meal. Gastric emptying rates of solids and fat (T50% accelerated by 16 and by 22%, p < 0.05, respectively) were significantly faster after duodenal perfusion of orlistat; gallbladder contraction and CCK release were reduced under these conditions (p < 0.005, respectively). With oral orlistat no significant effect was documented on these parameters. We conclude that fat hydrolysis is essential in the regulation of fat-induced gastric emptying and gallbladder contraction.
authors.affiliation: Department of Research and Clinical Research Centre, University Hospital, Basel, Switzerland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Degen
authors.forename: Daniel
authors.initials: D
authors.lastname: Matzinger
authors.forename: Juergen
authors.initials: J
authors.lastname: Drewe
authors.forename: Sonja
authors.initials: S
authors.lastname: Nisslé
authors.forename: Helmut
authors.initials: H
authors.lastname: Maecke
authors.forename: Hans
authors.initials: H
authors.lastname: Lengsfeld
authors.forename: Paul
authors.initials: P
authors.lastname: Hadvary
authors.forename: Christoph
authors.initials: C
authors.lastname: Beglinger
mesh_terms: D000328:Adult; D002766:Cholecystokinin / Q000187:drug effects / Q000378:metabolism*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D005217:Fat Emulsions, Intravenous; D005230:Fatty Acids, Nonesterified / Q000097:blood / Q000378:metabolism*; D016473:Gallbladder Emptying / Q000187:drug effects* / Q000502:physiology; D005746:Gastric Emptying / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007783:Lactones / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D000077403:Orlistat; D011863:Radioimmunoassay; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity
chemical_list: D004791:Enzyme Inhibitors; D005217:Fat Emulsions, Intravenous; D005230:Fatty Acids, Nonesterified; D007783:Lactones; D002766:Cholecystokinin; D000077403:Orlistat