Gastric Fundus (gastric + fundu)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

One-hour fast for water and six-hour fast for solids prior to endoscopy provides good endoscopic vision and results in minimum patient discomfort

Arjuna P De Silva
Abstract Background and Aim:, Current guidelines for upper gastrointestinal endoscopy (UGIE) advise at least 6,8 h fasting for solids and 4-h fasting for liquids. We aimed to determine whether a 6-h fast for solids and one-hour fast for water prior to UGIE gives good endoscopic vision and less patient discomfort. Methods:, 128 patients referred for UGIE were given a standard meal 6 h before endoscopy, and then randomized to either nil by mouth for 6 h (group A, n = 65) or allowed to drink water for up to one hour prior to endoscopy (group B, n = 63). Before endoscopy patients were requested to indicate discomfort due to fasting on a visual analog scale. Fluid in the gastric fundus was aspirated, when present, for volume and pH measurements, and endoscopic vision was graded. Results:, 53 patients in group A and 43 patients in group B completed the study. Discomfort was significantly lower in group B than group A (P < 0.0001). Endoscopic vision was good in all 53 patients in group A and 40 in group B, and average in 3 patients in group B. Fluid in the gastric fundus was noted in 11 patients in group A and 16 in group B, but there were no significant differences in volume or pH between groups. There were no complications attributable to endoscopy in either group. Conclusions:, A 6-h fast for solids and a 1-h fast for water prior to UGIE gives good endoscopic vision, and causes minimum patient discomfort. [source]

Tension and stress in the rat and rabbit stomach are location- and direction-dependent

J. Zhao
Abstract, Distension studies in the stomach are very common. It is assumed in pressure,volume (barostat) studies of tone and tension in the gastric fundus that the fundus is a sphere, i.e. that the tension in all directions is identical. However, the complex geometry of the stomach indicates a more complex mechanical behaviour. The aim of this study was to determine uniaxial stress,strain properties of gastric strips obtained from rats (n = 12) and rabbits (n = 10). Furthermore, we aimed to study the gastric zero-stress state since the stomach is one of the remaining parts of the gastrointestinal tract where residual strain studies have not been conducted. Longitudinal strips (in parallel with the lesser curvature) and circumferential strips (perpendicular to the lesser curvature) were cut from the gastric fundus (glandular part) and forestomach (non-glandular part). The residual stress was evaluated as bending angles (unit: degree per unit length and negative when bending outwards). The residual strain was computed from the change in length between the zero-stress state and no-load state. The stress,strain test was performed using a tensile test machine. The thickness and width of each strip were measured from digital images. The strips data were compared with data obtained in the intact stomach in vitro. Most residual stresses and strains were bigger in the glandular part than in the forestomach, and in general the rat stomach had higher values than the rabbit stomach. The glandular strips were stiffer than the forestomach strips and the longitudinal glandular strips were stiffer than the circumferential glandular strips (P < 0.05). The gastric strips were stiffer in rats than in rabbits (P < 0.01). The data obtained in the intact rat stomach confirmed the strips data and indicated that those were obtained in the physiological range. In conclusion, the biomechanical properties of the gastric strips from the rat and rabbit are location-dependent, direction-dependent and species-dependent. The assumption in physiological pressure,volume studies that the stomach is a sphere with uniform tension is not valid. Three-dimensional geometric data obtained using imaging technology and mechanical data are needed for evaluation of the stomach function. [source]

The herbal preparation STW5 (lberogast®) has potent and region-specific effects on gastric motility

B. Hohenester
Abstract, Functional dyspepsia (FD) is amongst the most common functional gastrointestinal disorders. Symptomatic treatment includes the use of herbal preparations whose effects on gastric motility are unclear. The present study aimed at investigating the effects of STW 5 (Iberogast®), a fixed combination of hydroethanolic herbal extracts, on gastric motility in vitro. Muscle strips from guinea-pig gastric fundus, corpus and antrum were set up in organ baths either in circular or longitudinal orientation. Addition of ethanol-free STW 5 to the organ baths (32,512 ,g mL,1) dose-dependently evoked a sustained and reversible relaxation of circular and longitudinal fundus and corpus muscle strips without changes in phasic activity. In contrast, antral muscle strips responded to STW 5 with a significant increase in the contractile force of phasic contractions without changes in tone. All effects were resistant to tetrodotoxin (0.5 ,mol L,1), atropine (1 ,mol L,1), , -conotoxin GVIA (0.5 ,mol L,1), capsaicin (1 ,mol L,1) or l -NAME (100 ,mol L,1), suggesting that neither nerves nor nitric oxide pathways were involved. These data demonstrate that STW 5 profoundly alters gastric motility in a region-specific but not layer-specific manner and thus implicates Iberogast® in the treatment of FD patients suffering from motility disorders with impaired fundus accommodation and/or antral hypomotility. [source]

Neuronal correlates of gastric pain induced by fundus distension: a 3T-fMRI study

C.-L. Lu
Abstract Visceral hypersensitivity in gastric fundus is a possible pathogenesis for functional dyspepsia. The cortical representation of gastric fundus is still unclear. Growing evidence shows that the insula, but not the primary or secondary somatosensory region (SI or SII), may be the cortical target for visceral pain. Animal studies have also demonstrated that amygdala plays an important role in processing visceral pain. We used fMRI to study central projection of stomach pain from fundus balloon distension. We also tested the hypothesis that there will be neither S1 nor S2 activation, but amygdala activation with the fundus distension. A 3T-fMRI was performed on 10 healthy subjects during baseline, fullness (12.7 ± 0.6 mmHg) and moderate gastric pain (17.0 ± 0.8 mmHg). fMRI signal was modelled by convolving the predetermined psychophysical response. Statistical comparisons were performed between conditions on a group level. Gastric pain activated a wide range of cortical and subcortical structures, including thalamus and insula, anterior and posterior cingulate cortices, basal ganglia, caudate nuclei, amygdala, brain stem, cerebellum and prefrontal cortex (P < 0.001). A subset of these neuronal substrates was engaged in the central processing of fullness sensation. SI and SII were not activated during the fundus stimulation. In conclusion, the constellation of neuronal structures activated by fundus distension overlaps the pain matrices induced musculocutaneous pain, with the exception of the absence of SI or SII activation. This may account for the vague nature of visceral sensation/pain. Our data also confirms that the insula and amygdala may act as the central role in visceral sensation/pain, as well as in the proposed sensory-limbic model of learning and memory of pain. [source]

Randomized controlled trial of laparoscopic anterior versus posterior fundoplication for gastro-oesophageal reflux disease

Mansoor Khan
Abstract Background:, The aim of the study was to compare the effect of laparoscopic anterior and posterior fundoplication on gastro-oesophageal reflux disease by means of a prospective randomized controlled trial. Methods:, One hundred and three patients were randomised to undergo either anterior (53) or posterior (50) fundoplication. Initial enrolment and subsequent clinical appointments were undertaken 1, 3, 6 and 12 months after the procedure using a standardized questionnaire. Ambulatory pH monitoring and manometry were undertaken both preoperatively and at approximately 3 months post-procedure. Results:, The mean operating time was similar in both groups (48 versus 52 min). Two operations in each group were converted to open surgery. Post-operative dysphagia in the first month was higher in the posterior fundoplication group compared with the anterior group (at 1 month, P= 0.002; and at 3 months, P= 0.014). The number of individuals suffering from post-operative heartburn was greater in the anterior fundoplication group (at 1 month, P= 0.008; at 3 months, P < 0.001; and at 6 months, P= 0.002). Eight individuals required reoperation in the anterior group and two individuals in the posterior group (P= 0.057). Conclusion:, Anterior and posterior fundoplication each have their advantages and disadvantages. There is an increased risk of early post-operative dysphagia after posterior fundoplication. Anterior fundoplication carries a greater risk of persistent or recurrent reflux. Overall, a posterior fundoplication produces a better management option for controlling gastro-oesophageal reflux disease when compared with an anterior fundoplication technique which utilizes unilateral fixation of the gastric fundus. [source]

Investigation of enhancement effects of nicotine on cholinergic neurotransmission in isolated rabbit gastric fundus: role of antioxidants

A. Anuvarbekova
Summary 1,Nicotine, which is tobacco alkaloid, still induces interests for researchers because of smokers addiction to nicotine. Nicotine having influence on the neuronal acetylcholine receptors (nAChRs) increases release of most certain neurotransmitters from the nerve endings. Also, nicotine, affecting the mitochondrial respiratory chains, contributes to the formation of reactive oxygen species. 2,In the present study, we investigated the effects of nicotine on smooth muscles of gastric fundus on the electrical field stimulation (EFS) that induces transition contraction via stimulation nAChRs. In addition, we aimed to investigate the interaction between release of acetylcholine, induced by nicotine, and the effects of reactive oxygen species. 3,Therefore, the effects of allopurinol (10,6,10,5 m), deferoxamine (10,4 m) and mannitol (10,4,5 × 10,3 m) were tested on the transient contraction induced by nicotine. 4,In conclusion, mannitol (5 × 10,3 m) significantly reduced contractile response to nicotine on EFS only in high concentration. Whereas in small concentrations mannitol (10,4 m) statistically did not cause any results. Deferoxamine and allopurinol also did not have any significant response. [source]

Evidence for VIP1/PACAP receptors in the afferent pathway mediating surgery-induced fundic relaxation in the rat

G E Boeckxstaens
We previously reported activation of an inhibitory adrenergic and a non-adrenergic non-cholinergic (NANC) pathway during abdominal surgery relaxing the rat gastric fundus. In the present study, we investigated the possible role of nitric oxide (NO) and vasoactive intestinal polypeptide (VIP) in the NANC part of the surgery-induced fundic relaxation. The effect of the NO biosynthesis inhibitor NG -nitro- L -arginine (L -NOARG), the non-selective VIP receptor antagonist [D -p-Cl-Phe6,Leu17]-VIP and the selective VIP1 receptor antagonist [Acetyl-His1,D -Phe2,Lys15,Arg16,Leu17]-VIP was investigated on the non-adrenergic fundic relaxation induced by manipulation of the small intestine followed by resection of the caecum. Guanethidine partly reduced the manipulation-induced fundic relaxation. Addition of L -NOARG reduced this non-adrenergic component, whereas the non-selective VIP receptor antagonist had no significant effect. Combination of L -NOARG and the non-selective VIP antagonist however further reduced the relaxation to manipulation. The selective VIP1 receptor antagonist reduced the mean and maximal relaxation induced by abdominal surgery in the presence of guanethidine. When combined with L -NOARG, the relaxation of the gastric fundus was almost completely abolished. The VIP1 receptor antagonist alone had no significant effect on the mean and maximal relaxation, but enhanced recovery of fundic tone. In conclusion, as VIP1 receptors are not present in the rat gastric fundus, these results suggest that the NANC inhibitory pathway activated during abdominal surgery involves VIP1 receptors, most likely in the afferent limb. The inhibitory neurotransmitters released at the level of the gastric fundus smooth muscle are NO and a substance different from VIP. British Journal of Pharmacology (2000) 131, 705,710; doi:10.1038/sj.bjp.0703625 [source]