Intestine motility

Biologica.1 Activities a.ndAna.logues, The many pharmacological actions of neurotensin include hypotension, increased vascular permeabihty, hyperglycemia, increased intestinal motility, and inhibition of gastric acid secretion (120). In the brain, it produces analgesia at remarkably low doses (121). 

They also are important portals for systemic therapy. However, many variables can influence dmg dissolution and absorption ia these areas, including rate of gastric emptying, intestinal motility, mass and pH of intestinal contents, and condition of the absorbiag surfaces (15—17). These variables, ia turn, can be affected by the patient s disease, posture, and eating habits, and even by such aspects of the treatment as the timing of doses (11). 

Paralytic ileus 4. Increased AEA levels participate in inhibition of small intestine motility 4. CB antagonists... 

Constipation, caused by a decrease in intestinal motility, may occur in tiiose taking one of tiiese drag s on a regular basis. Drowsiness may occur widi die use of diese dm, but at times tins adverse reaction is desirable Fbr example when atropine is used preoperatively to reduce die production of secretions in die respiratory tract, drowsiness is part of die desired response... 

Because of the effect of cholinergic blocking dm on intestinal motility, the nurse must monitor the patient taking these dragp for file development of... 

If a series of related chemicals, say noradrenaline, adrenaline, methyladrenaline and isoprenaline, are studied on a range of test responses (e.g. blood pressure, heart rate, pupil size, intestinal motility, etc.) and retain exactly the same order of potency in each test system, then it is likely that there is only one type of receptor for all four of these catecholamines. On the other hand, if, as Ahlquist first found in the 1940s, these compounds give a distinct order of potency in some of the tests, but the reverse (or just a different) order in others, then there must be more than one type of receptor for these agonists. 

Lubiprostone (Amitiza), a bicyclic acid oral agent, is approved for treatment of chronic idiopathic constipation in adults. It has not been studied in children. Lubiprostone acts locally on intestinal chloride channels and increases intestinal fluid secretion, resulting in increased intestinal motility and thereby increasing the passage of stool.6... 

Disturbed intestinal motility appears to be a central feature of IBS, which leads to altered stool consistency. Studies suggest that the colon of IBS sufferers is abnormally sensitive to normal stimuli.13 This enhanced visceral sensitivity manifests as pain, especially related to gut distention. 

Cholelithiasis can develop as a result of decreased gallbladder contractility, especially in the absence of enteral or oral intake. Lack of intestinal stimulation reduces secretion of cholecys-tokinin, a peptide hormone secreted in the duodenum that induces gallbladder contractility. The best prevention of cholelithiasis is early initiation of enteral or oral feeding, as stated earlier (to stimulate secretion of cholecystokinin, gallbladder contraction and emptying, and intestinal motility). 

Methylxanthines affect gastric and intestinal motility, but probably not the mouth-to-cecum transit time. 

Cannabimimetics reduce the intestinal motility by a CB1-mediated inhibitory activity on acetylcholine release from autonomic fibers. An endo-cannabinoid, 2-AG, was isolated from dog intestine however, its role there remains unknown (Mechoulam, 1995a). 

Galligan JJ, Mosberg HI, Hurst R, Hruby VJ, Burks TF. Cerebral delta opioid receptors mediate analgesia but not the intestinal motility effects of intracerebroventricularly administered opioids. J Pharmacol Exp Ther 1984 229 641-648. 

A summary of how physiological factors affect the dissolution rate is given in Table 21.2. The effective surface area will be affected by the wetting properties of the bile acids and other surface-active agents in the gastrointestinal tract. The dif-fusivity of a drug molecule in the intestinal juice will be altered by changes in viscosity that are induced, for instance, by meal components. An increased dissolution rate could be obtained at more intense intestinal motility patterns or increased... 

Fig. 5. Relationship between fasting intestinal motility [x-axis migrating motor complex (MMC) index] and bacterial colonization of small bowel in 41 patients with late radiation enteropathy (LRE) is shown by two plots. Relationship to Gram-negative bacilli (a) and to total bacterial count (b) in the duodenum is shown. Note that no significant Gram-negative colonization was found in patients with normal MMC (index = 3). The vertical dotted lines show the normal limit for MMC index. Increased bacterial counts due to URT flora were found in some patients with normal MMC (b). Tied observations are indicated as follows n = 1 n = 2 1 n = 3 1 n = 4 + n = 6 For n > 6...

Intestinal clearance is henceforth defined as the ability of the small bowel to clear its lumen of bacteria. The known conditions of major clinical importance for intact intestinal clearance are (1) normal gastrointestinal anatomy, including the absence of intestinal diverticula and fistula, and (2) normal intestinal motility. 

Although hereditary neuropathies and myopathies affecting small intestinal motility are rare, the entire spectrum of diseases that can interfere with motility is wide, including for example diabetes mellitus, Crohn s disease, scleroderma, and postoperative and radiation sequelae [21,71, 116, 123, 131]. 

Failure of intestinal motility can be severe leading to frank intestinal pseudoobstruction [122, 132] or mild to moderate depending on the underlying disease, its severity, and the degree of intestinal involvement. 

Vagal neuropathy in diabetes mellitus [145, 146] and truncal vagotomy [147] may markedly change intestinal motility, as do heart-lung transplantation [148]. Spinal cord lesions also alter gut function, but the outlet obstruction due to failure of the striated muscles involved in defecation is more important than the enteric smooth muscle effects [149]. 

Radiation Injury. Late radiation enteropathy is associated with alterations of small intestinal motility [154], intestinal pseudoobstruction [154, 155] and Gram-negative colonization of the small bowel in patients with impaired small bowel motility [12], In patients with severe injury, alterations in the motility and microflora are of main importance for the clinical symptoms [154],... 

Inflammation. Chronic inflammatory bowel disease affecting the small bowel can lead to disturbances of intestinal motility [146], Potential mechanisms are previous surgery, development of fibrosis and strictures, malabsorption, and cross-talk between inflammatory and enteric nerves [156, 157], Patients with Crohn s disease are often included in aggregate studies of bacterial overgrowth [23, 75, 158], reflecting this link. 

Dysmotility has been reported in Lyme disease [166] and in postviral syndromes associated with cytomegalovirus and herpes simplex virus [167], Altered intestinal motility can also be part of infectious mononucleosis [168]. 

The absence of Gram-negative bacilli is a reliable and valid indication of preserved intestinal clearance, which precludes a significant failure of intestinal motility and anatomical abnormalities inducing stasis or recycling of contents from the lower gastrointestinal tract. 

Code CF, Schlegel JF The gastrointestinal housekeeper. Motor correlates of the interdigestive myoelectric complex of the dog. Proceedings from the 4th International Symposium on Gastro-Intestinal Motility. Vancouver, Mitchell Press, 1974, pp 631-634. 

Di Lorenzo C, Flores AF, Buie T, Hyman PE Intestinal motility and jejunal feeding in children with chronic intestinal pseudo-obstruction. Gastroenterology 1995 108 1379-1385. 

Quigley EMM Gastric and small intestinal motility in health and disease in Camilleri M (ed) Gastrointestinal Motility in Clinical Practice. Philadelphia, Saunders, 1996, pp 113— 147. 

Weisbrodt NW Intestinal motility in Johnson LR (ed) Physiology of the Gastrointestinal Tract. New York, Raven Press, 1987, pp 631-663. 

Riordan SM, Mclver CJ, Walker BM, Dun-combe VM, Bolin TD, Thomas MC Bacteriological method for detecting small intestinal motility. Am J Gastroenterol 1996 91 2399-2405. 

Thompson DG, Ritchie HD, Wingate DL Pattern of small intestine motility in duodenal ulcer patients before and after vagotomy. Gut 1982 23 517-523. 

Nowak TV, Anuras S, Brown BP, Ionasescu V, Green JB Small intestinal motility in myotonic dystrophy patients. Gastroenterology 1984 86 808-813. 

Soudah HC, Hasler WL, Owyang C Effect of octreotide on intestinal motility and bacterial overgrowth in scleroderma. N Engl J Med 1991 325 1461-1467. 

Quigley EMM The effects of resection, restorative procedures and transplantation on intestinal motility in Kumar D, Wingate D (eds) An Illustrated Guide to Gastrointestinal Motility. Edinburgh, Churchill Livingstone, 1993, pp 691-716. 

Strid H, Simren M, Stotzer PO, Ringstrom G, Abrahamsson H, Bjornsson ES Patients with chronic renal failure have abnormal small intestinal motility and a high prevalence of small intestinal bacterial overgrowth. Digestion 2003 67 129-137. 

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