title: Migrating motor complex in colectomized ileo stoma patients.
abstract: In colectomized patients with ileo stoma, the reflex modulation of small intestinal functions is disturbed, resulting in high enteric stoma outputs and malabsorption. Serotonin has a pivotal role in initiating motor and secretory reflexes involving activation of neuronal 5-HT(3) and smooth muscle muscarinic receptors. We aimed to evaluate the effect of 5-hydroxytryptamine (5-HT), ondansetron and atropine on fasting and stimulated antro-duodeno-jejunal migrating motor complex (MMC) in colectomized patients with ileo stoma compared with healthy subjects. Manometric recordings were obtained in a blinded, age- and gender-matched design. The effects of either standard meal or intravenous 5-HT (10 nmol/kg/min.) treatment with pre-treatment of saline (placebo) or ondansetron (250 μg/kg) or atropine (10 μg/kg) were compared. Adverse effects, blood pressure, heart rate and electrocardiographic data were also evaluated. 5-HT increased the frequency (threefold) and migration velocity (twofold) of MMC phase III in both experimental groups. Ondansetron reduced 5-HT-induced frequency of MMC phase III in patients (p < 0.05) but not in healthy subjects. Atropine reduced 5-HT-induced frequency of MMC phase III in healthy subjects (p < 0.05). Ondansetron did not alter fasting or postprandial MMC in either experimental group (p > 0.05). Atropine did not change fasting MMC in healthy subjects (p > 0.05). We conclude that 5-HT is a stimulator of MMC phase III and that ondansetron reduces the 5-HT-induced MMC phase III without affecting fasting or postprandial properties in colectomized patients with ileo stoma. Similar effects were observed for 5-HT and atropine in healthy subjects.
authors.affiliation: Department of Surgery D, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark. mbh@dadlnet.dk
authors.forename: Mark B
authors.initials: MB
authors.lastname: Hansen
authors.forename: Lene
authors.initials: L
authors.lastname: Wallin
authors.forename: Einar
authors.initials: E
authors.lastname: Husebye
authors.forename: Louise
authors.initials: L
authors.lastname: Dommergaard
authors.forename: Hans
authors.initials: H
authors.lastname: Gregersen
mesh_terms: D000328:Adult; D000368:Aged; D001285:Atropine / Q000494:pharmacology; D016022:Case-Control Studies; D003082:Colectomy; D004386:Duodenum / Q000002:abnormalities / Q000187:drug effects; D005215:Fasting; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007409:Intestinal Atresia; D007415:Intestinal Obstruction; D007421:Intestine, Small / Q000187:drug effects* / Q000294:innervation*; D007583:Jejunum / Q000002:abnormalities / Q000187:drug effects; D008297:Male; D008365:Manometry; D008638:Mesenteric Arteries / Q000002:abnormalities / Q000187:drug effects; D008643:Mesentery / Q000002:abnormalities / Q000187:drug effects; D008875:Middle Aged; D009130:Muscle, Smooth / Q000187:drug effects; D016065:Myoelectric Complex, Migrating / Q000187:drug effects*; D017294:Ondansetron / Q000494:pharmacology; D012701:Serotonin / Q000494:pharmacology; D055815:Young Adult
chemical_list: D012701:Serotonin; D017294:Ondansetron; D001285:Atropine