Vol. 275, Issue 3, R762-R769, September 1998
Human duodenogastric reflux, retroperistalsis, and
MMC
Jan
Dalenbäck1,
Hasse
Abrahamson2,
Einar
Björnson2,
Lars
Fändriks1,
Anna
Mattsson3,
Lars
Olbe1,
A.-M.
Svennerholm3, and
Henrik
Sjövall2
Departments of 1 Surgery,
2 Internal Medicine, and
3 Microbiology, Center of
Gastrointestinal Research, Sahlgrenska University Hospital, University
of Göteborg, S-413 45 Göteborg, Sweden
The aim of
this study was to determine to what extent human migrating motor
complex (MMC)-related secretory phenomena are influenced by a recently
discovered period of duodenal retroperistalsis during late phase III. A
constant-flow perfusion technique was used to measure gastric
appearance of acid, bicarbonate, pepsin, bilirubin, IgA, and duodenally
infused
[14C]polyethylene
glycol (PEG) 4000 in 12 healthy volunteers. Interdigestive gastroduodenal motility was recorded by digital manometry. During late
antral phase II and III, the gastric lumen was acidified (P < 0.005 phase III vs. phase I)
together with a marked increase in luminal pepsin output (3.1 ± 1.2 during phase III vs. 0.25 ± 0.08 kU/5 min in phase I,
P < 0.01), followed by a
realkalinization due to a simultaneous reduction of acid secretion and
a duodenogastric reflux, aided by retrograde peristalsis, of
bicarbonate and IgA but not of bilirubin, at the end of antral phase
III (P < 0.05 phase III vs. phase I
values). This physiological duodenoantral reflux phenomenon may play an
important role in the chemical and immunological restitution of the
antral mucosal barrier function after the exposure to high acid and
pepsin concentrations during antral phase III activity.
stomach; duodenum; antrum; acid secretion; bicarbonate secretion; bile reflux; secretory immunoglobulin A; pepsin; migrating motor
complex
