RESUMEN
The factors that influence colonic transit time in healthy humans are not yet clearly defined. The aim of this study was therefore to determine (a) if there are differences in colonic transit time between men and women and (b) if age, female hormonal status or smoking habits are associated with alterations in these parameters. Colonic transit time was measured in 164 asymptomatic subjects (80 males, 84 females) by a radio-opaque marker technique with one single plain abdominal X-ray. Colonic transit time was significantly shorter in men than in women (30 +/- 2 vs. 42 +/- 3 h, P < 0.05). Colonic transit time in non-smoking males was significantly shorter compared with smoking males (26 +/- 2 vs. 40 +/- 5 h, P < 0.05). In females only height and menstrual cycle influenced colonic transit times. We conclude that gender and smoking habits should be considered when studying colonic transit time in health and disease.
Asunto(s)
Envejecimiento/metabolismo , Colon/metabolismo , Tránsito Gastrointestinal/fisiología , Hormonas/fisiología , Caracteres Sexuales , Fumar/metabolismo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de ReferenciaRESUMEN
Fifty-four patients examined for noncardiac chest pain (NCCP), showing no esophageal motor disorder or gastroesophageal reflux disease compatible with NCCP, were subjected to an intraesophageal balloon distension test and a study of the belching reflex provoked by intraesophageal air injection. Thirty-three control subjects were also studied, allowing us to define high-threshold belchers (group I) as those who belched during two of three 40-ml distensions and low-threshold belchers (group II) as those who did not. The balloon distension test induced NCCP in 64% of the patients in group I, and in 14% of the patients in group II (P < 0.01). High-threshold belching was a factor favoring the positivity of the balloon distension test. This result supports the hypothesis that esophageal distension by air due to a belching disorder may be the mechanism responsible for NCCP in some patients with an abnormal sensitivity to balloon distension.
Asunto(s)
Dolor en el Pecho/etiología , Eructación/fisiopatología , Esófago/inervación , Reflejo Anormal/fisiología , Aire , Cateterismo , Dolor en el Pecho/epidemiología , Dolor en el Pecho/fisiopatología , Esófago/fisiopatología , Femenino , Humanos , Masculino , Manometría , Persona de Mediana Edad , Estudios ProspectivosAsunto(s)
Motilidad Gastrointestinal , Intestino Delgado/fisiología , Ayuno , Alimentos , Humanos , Manometría/métodosRESUMEN
Disturbances of small bowel motor function are increasingly recognized in clinical practice, either in the setting of an underlying disease that may affect the neuro-hormonal control of gut motility, such as diabetes or scleroderma, or as part of unexplained intestinal dysfunctions such as the irritable bowel syndrome or chronic idiopathic intestinal pseudo-obstruction. In the absence of endoscopic or radiological mucosal disease, it is often clinically helpful to define the motor function of the small bowel to understand the origin of the patient's symptoms. The hydrogen breath test after a lactulose oral load is currently used to measure mouth to caecum transit time. However, the reproducibility of this test is poor, and the range of normal values is wide. Scintigraphic determination of small intestinal transit time overcomes some of the limitations of the hydrogen breath test. This is however a time consuming procedure--up to 10 hrs when the time for acquisition, processing and analysis is included--and the costs prohibit widespread application of the technique. It is further restricted by the exposure to ionising radiation, particularly if repeated evaluations are necessary, for example in drugs trials. Manometry records mechanical activity of the bowel and detects quantitative and qualitative changes of small intestinal motility. As with scintigraphy, high costs and radiation exposure limit its usefulness. The major clinical application of the technique is in the diagnosis of chronic intestinal pseudo-obstruction.
Asunto(s)
Motilidad Gastrointestinal , Enfermedades Intestinales/fisiopatología , Pruebas Respiratorias , Estreñimiento/fisiopatología , Diarrea/fisiopatología , Tránsito Gastrointestinal , Humanos , Hidrógeno/análisis , Enfermedades Intestinales/diagnóstico por imagen , Seudoobstrucción Intestinal/fisiopatología , Manometría/métodos , CintigrafíaRESUMEN
Constipation and incontinence frequently lead to medical consultation. A careful history and a complete physical examination of both anus and rectum are required before performing anorectal motility tests, the most important of which are anorectal manometry coupled with electromyography of the external anal sphincter and defecography. The pathophysiologic origin of these symptoms can then be understood. This has led to the development of new therapies such as bio-feedback or corrective surgery.
Asunto(s)
Enfermedades del Ano/fisiopatología , Motilidad Gastrointestinal , Enfermedades del Recto/fisiopatología , Anciano , Canal Anal/fisiopatología , Estreñimiento/fisiopatología , Defecación , Electromiografía , Incontinencia Fecal/fisiopatología , Femenino , Humanos , Masculino , Manometría/métodos , Persona de Mediana EdadRESUMEN
A patient with hypertrophic cardiomyopathy developed unilateral right sided pulmonary oedema. Pulmonary angiography showed a proximal severe narrowing of the left pulmonary artery.
Asunto(s)
Cardiomiopatía Hipertrófica/complicaciones , Arteria Pulmonar/patología , Edema Pulmonar/complicaciones , Adulto , Cardiomiopatía Hipertrófica/diagnóstico por imagen , Constricción Patológica , Femenino , Humanos , Arteria Pulmonar/diagnóstico por imagen , Edema Pulmonar/diagnóstico por imagen , RadiografíaRESUMEN
Pancreatico-biliary diversion (PBD) stimulates pancreatic growth in the rat. The present experiment was designed to investigate the mechanism of this phenomenon. The potential roles of endogenous CCK, gastrin, and secretin were studied. Hormone measurements by specific RIA's show that PBD was associated with higher CCK plasma concentrations and, conversely, with lower gastrin circulating levels. Secretin and pancreatic polypeptide were unaffected by PBD. Seven days' subcutaneous administration of proglumide (1000 mg/kg/day), benzotript (100 mg/kg/day), two CCK and gastrin receptor antagonists, and Ranitidine (100 mg/kg/day) resulted in a significant inhibition of PBD-induced pancreatic growth, assessed by measurements of pancreatic weight, DNA, RNA and protein content. These results suggest, therefore, that CCK plays a central role in the development of the pancreatic adaptive response to PBD.