Gastrointestinal tract gastric emptying

Gastrointestinal sphincters are formed where the circular layer of smooth muscle is thickened. Sphincters occur at several points along the tract. Their function is to limit the movement of food materials from one region to another. For example, the pyloric sphincter found between the stomach and duodenum of the small intestine plays an important role in limiting the rate of gastric emptying. Sphincters undergo tonic contractions that may be sustained for minutes or hours. 

After oral ingestion, ethanol pharmacokinetics must take into account (1) Absorption from the gastrointestinal tract. Since ethanol is absorbed most efficiently from the small intestines, the rate of gastric emptying is an important factor that governs the rate of rise of blood alcohol concentration (BAC), i.e., the slope of the ascending limb of the BAC-time curve, and the extent of first pass metabolism of ethanol by the liver and stomach. (2) Distribution of ethanol in the body. Ethanol distributes equally in total body water, which is related to the lean body mass of the person, and (3) the elimination of ethanol from the body, which occurs primarily by metabolism in the liver, first to acetaldehyde and then to acetate [7]. 

Mayer EA The physiology of gastric storage and emptying in Johnson LR, Alpers DH, Christensen J, Jacobson ED, Walsh JH (eds) Physiology of the Gastrointestinal Tract. New York, Raven Press, 1994, pp 929-976. 

The gastrointestinal tract is the only system outside the central nervous system (CNS) with significant concentrations of opioid receptors. This reflects their common embryonic origins. Opioids increase intestinal tone and decrease propulsive peristalsis, resulting in delayed gastric emptying and constipation or ileus. Opioids increase common bile duct pressure and decrease bile production and flow, primarily because of spasm of the sphincter of Oddi. The tone of the bile duct itself is also increased. 

Altering the rate of gastric emptying and lower gastrointestinal tract transit influences the absorption of any co-administered drugs. 

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