Intestinal Intraluminal Continuity Is a Prerequisite for the Distal Bowel Motility Response to Feeding

Abstract

Background: We wanted to elucidate further the regulation of the intestinal motility response to feeding. Methods: After intraduodenal administration of an oleate solution, mimicking a meal, the distal bowel motility and the plasma levels of bile acids, cholecystokinin (CCK), and neurotensin were monitored in patients operated on with restorative proctocolectomy (n = 4) or low anterior resection of the rectum (n = 4). Investigations were performed both with and without a diverting loop ileostomy. Results: Intraduodenal sodium oleate elicited a prompt and significant increase in distal bowel motility. The motility response failed to appear when the luminal flow was diverted by a loop ileostomy. An increase in plasma CCK preceded the motility increase, but CCK was increased also in patients with a loop ileostomy. Whereas plasma bile acid levels were significantly increased after 30-45 min (p < 0.05), both with and without a loop ileostomy, neurotensin levels were not affected. Conclusion: Intestinal continuity is a prerequisite for the distal bowel motility response, indicating that apart from other possible mechanisms, luminal factors are involved in the regulation of intestinal motility.

Key Words:

• Bile acids
• cholecystokinin
• neurotensin
• oleic acid
• restorative proctocolectomy