Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 7, 2006; 12(37): 6008-6016
Published online Oct 7, 2006. doi: 10.3748/wjg.v12.i37.6008
Postprandial transduodenal bolus transport is regulated by complex peristaltic sequence
Huan Nam Nguyen, Ron Winograd, Gerson Ricardo Souza Domingues, Frank Lammert
Huan Nam Nguyen, Ron Winograd, Gerson Ricardo Souza Domingues, Frank Lammert, Department of Medicine III, Division of Gastroenterology, Aachen University (RWTH), Aachen, Germany
Supported by a grant of the University of Aachen “START-Project”
Correspondence to: Huan Nam Nguyen, MD, Department of Internal Medicine, Elisabeth-Krankenhaus Rheydt, University of Technology RWTH-Aachen, Hubertusstr. 100, D 41239 Mönchengladbach, Germany.
Telephone: +49-2166-3942121 Fax: +49-2166-3942711
Received: May 7, 2006
Revised: May 20, 2006
Accepted: June 14, 2006
Published online: October 7, 2006

AIM: To study the relationship between the patterns of postprandial peristalsis and transduodenal bolus transport in healthy subjects.

METHODS: Synchronous recording of chyme transport and peristaltic activity was performed during the fasting state and after administration of a test meal using a special catheter device with cascade configuration of impedance electrodes and solid-state pressure transducers. The catheter was placed into the duodenum, where the first channel was located in the first part of the duodenum and the last channel at the duodenojejunal junction. After identification of previously defined chyme transport patterns the associated peristaltic patterns were analyzed.

RESULTS: The interdigestive phase 3 complex was reliably recorded with both techniques. Of 497 analyzed impedance bolus transport events, 110 (22%) were short-spanned propulsive, 307 (62%) long-spanned propulsive, 70 (14%) complex propulsive, and 10 (2%) retrograde transport. Short-spanned chyme transports were predominantly associated with stationary or propagated contractions propagated over short distance. Long-spanned and complex chyme transports were predominantly associated with propulsive peristaltic patterns, which were frequently complex and comprised multiple contractions. Propagated double wave contraction, propagated contraction with a clustered contraction, and propagated cluster of contractions have been identified to be an integralted part of a peristaltic sequence in human duodenum.

CONCLUSION: Combined impedancometry and manometry improves the analysis of the peristaltic patterns that are associated with postprandial transduodenal chyme transport. Postprandial transduodenal bolus transport is regulated by propulsive peristaltic patterns, which are frequently complex but well organized. This finding should be taken into consideration in the analysis of intestinal motility studies.

Keywords: Transduodenal bolus transport, Organization of duodenal peristalsis, Combined impedance manometry