Pylorus

For patients intolerant of gastric feedings or in whom the risk of aspiration is high, feedings delivered with the tip of the tube past the pylorus into the duodenum or, preferably, the jejunum are preferred. 

Finney JMT Gastro-enterostomy for cicatrizing ulcer of the pylorus. Johns Hopkins Med J... 

Greater skill is required to place the feeding tube beyond the pylorus. Prokinetic agents, such as metoclopramide or erythromycin, facilitate... 

Sucralphate Should not be given in a duodenal tube since the effect is directly on a damaged mucosa in the stomach and pylorus. Change drug if the tube ends in the duodenum. 

The most potent activities (gastric antisecretory activity in the pylorus-ligated rat or anti-ulcer activity on stress-induced gastric lesion in rat) have been observed with compounds (30), (31) [106], (32) [107], (33) and (34) [108], which were shown neither to be histamine H2 receptor inhibitors nor to act as anticholinergic agents. Thus, the activity of compound (32), for example, has been reported to be superior to that of cimetidine [107],... 

Kumar D, Ritman EL, Malagelada JR. Three-dimensional imaging of the stomach role of pylorus in the emptying of liquids. Am J Physiol 1987 253 G79-G85. 

To simulate conditions lower in the small intestine, media are buffered at higher pH values and contain progressively lower concentrations of bile salts (see also the section Dissolution Test Design for MR Products ). These compositions reflect the active re-absorption of bile salts from the ileum, a process which is about 95% efficient, and the trend to higher pH as one moves further away from the pylorus. 

No histopathologic alterations were observed in the stomach, duodenum-pylorus, ileum, and colon of rats administered up to 3 mg/kg/day 1,3-DNB for 16 weeks or 14 mg/kg/day for 8 weeks in the drinking water (Cody et al. 1981). No further data were located regarding 1,3-DNB and no information was available regarding 1,3,5-TNB. 

Single doses may facilitate small bowel intubation when the tube does not pass the pylorus with conventional maneuvers. 

Facilitation of small bowel intubation - If the tube has not passed the pylorus with conventional maneuvers in 10 minutes, administer a single undiluted dose slowly IV over 1 to 2 minutes. 

Gastric emptying through the pylorus and into the duodenum is the next important event. This may occur rapidly or take up to one or two hours, depending largely on what is already in the stomach. So the effect of an oral drug may be delayed or hastened, by taking it with, or before, food. 

Vomiting and diarrhea from any cause will obviously alter the likelihood of any medication being absorbed. In migraine even before the attack is fully developed and before vomiting has occurred, gastric stasis exists. Taking a prophylactic dose of aspirin or paracetamol is unlikely to be effective if it does not pass the pylorus. Suppository forms of e.g., ergota-mine, have been developed to permit self medication early in the attack. 

Antiulcerogenic activity. Colloidal solution, administered orally to rats at a dose of 50 mg/kg, 60 minutes before experiment, produced significant protection against gastric ulcers induced by 2 hours cold restraint stress, aspirin, and 4 hours pylorus ligation " . ... 

Barocelli, E., Ballabeni, V., Chiavarini, M., Impicciatore, M., 1995. R-a-methylhistamine-induced inhibition of gastric acid secretion in pylorus-ligated rats via central histamine H3 receptors. Br. J. Pharmacol. 115, 1326-1330. 

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