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Am J Physiol Gastrointest Liver Physiol 287: G1028-G1034, 2004. First published June 10, 2004; doi:10.1152/ajpgi.00091.2004
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NEUROREGULATION AND MOTILITY

Stimulation of small intestinal burst activity in the postprandial state differentially affects lipid and glucose absorption in healthy adult humans

L. K. Bryant,1 R. J. Fraser,1 R. Vozzo,2 B. Zacharakis,3 G. M. Matthews,3 and R. Butler3

1Investigation and Procedures Unit, Repatriation General Hospital, Daw Park 5041; 2Department of Medicine, Royal Adelaide Hospital, Adelaide 5000; and 3Centre for Paediatric and Adolescent Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia 5006

Submitted 27 February 2004 ; accepted in final form 4 June 2004

Small intestinal motor activity is important for the optimal digestion and absorption of nutrients. These motor responses to feeding are frequently abnormal during critical illness, with the persistence of migrating bursts of contractions during enteral feeding. Whether this disturbance influences nutrient absorption is not known. In this study, the effects of small intestinal burst activity on lipid and glucose absorption were evaluated in 10 healthy human adults (6 males, 4 females, 19–47 yr). Upper gastrointestinal manometry was recorded for 6 h during and shortly after a 20-min intravenous infusion of either erythromycin (1 mg/kg), to stimulate burst activity, or saline (0.9%) in a double-blind randomized fashion. Simultaneously with the start of the intravenous infusion, 60 ml liquid feed mixed with 200 µl 13C-triolein and 2 g 3-O-methylglucose (3-OMG) was infused intraduodenally for 30 min. Absorption of lipid and glucose was assessed using the [13C]triolein breath test and plasma concentrations of 3-OMG, respectively. Infusion of erythromycin was followed by a more rapid onset of burst activity following commencement of the duodenal infusion compared with saline (30 ± 6.1 vs. 58 ± 10.7 min; P < 0.05). Erythromycin was associated with a slower recovery of 13CO2 (P < 0.01). A positive correlation existed between the time to onset of burst activity and 13CO2 recovery (P < 0.001). Erythromycin had no effect on 3-OMG absorption. In conclusion, stimulation of small intestinal burst activity reduces the rate of lipid absorption but not glucose absorption in healthy human adults.

motor activity; erythromycin; triolein; 3-O-methylglucose


Address for reprint requests and other correspondence: R. Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park, South Australia 5041 (E-mail: robert.fraser{at}rgh.sa.gov.au)






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