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Duodenal osmolality drives gallbladder emptying in humans

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Abstract

The effect of duodenal osmoreceptor stimulation on gallbladder motility was evaluated in 18 normal subjects during intraduodenal infusion of 280, 560 and 840 mosmlliters NaCl solutions. Gallbladder emptying was found to be dose-dependent between 560 and 840 mosm/liter (P<0.01 vs basal volume). The effect of duodenal infusion of hypertonic saline on gallbladder emptying was prevented by atropine and partially antagonized by naloxone,indicating that cholinergic and endorphinergic pathways may be involved in regulating this reflex. Since proglumide, a cholecystokinin (CCK) antagonist, did not affect gallbladder emptying induced by hypertonic saline, it seems likely that CCK is not released by increasing duodenal osmolality. A significant reduction in gallbladder volume was obtained when hyperosmolar saline was delivered into the duodenum, whereas no emptying was seen when infused into the gastric antrum or the jejunum, suggesting that osmoreceptors that activate gallbladder emptying are located only in the duodenum. Additionally, all subjects manifested central symptoms (nausea or vomiting) during duodenal infusion of hypertonic saline,suggesting that central mechanisms might be activated by a change in duodenal osmolality. Our data indicate that the osmolality of duodenal contents might regulate gallbladder motility by neural atropine- and naloxone-sensitive pathways.

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References

  1. Ryan JP: Motility of the gallbladder and biliary tree.In Physiology of Gastrointestinal Tract. LR Johnson (ed). New York, Raven Press, 1987, pp 695–721

    Google Scholar 

  2. Hunt JN: Some properties of an alimentary osmoreceptor mechanism. J Physiol 132:2677–2688, 1956

    Google Scholar 

  3. Hunt JN: The duodenal regulation of gastric emptying. Gastroenterology 43:149–156, 1963

    Google Scholar 

  4. Meerof JC, Go WLW, Phillips SD: Control of gastric emptying by duodenal contents in man. Gastroenterology 68:1144–1151, 1975

    Google Scholar 

  5. Fisher RS, Rock E, Malmud LS: Effects of meal composition on gallbladder and gastric emptying in man. Dig Dis Sci 32:1337–1344, 1987

    Google Scholar 

  6. Dodds WJ, Groth WJ, Darweesh RMA, Lawson TL, Kusher SMA, Kern MK: Sonographic measurement of gallbladder volume. Am J Radiol 145:1009–1011, 1985

    Google Scholar 

  7. Gullo L, Bolondi L, Priori P, Casanova P, Labó G: Inhibitory effect of atropine on cholecystokinin-induced gallbladder contraction in man. Digestion 29:209–213; 1984

    Google Scholar 

  8. Schiller LR, Walsh JH, Feldman M: Effect of atropine on gastrin release stimulated by aminoacid meal in humans. Gastroenterology 83:276–282, 1982

    Google Scholar 

  9. Fiorucci S, Bosso R, Farinelli M, Cascetta R, Morelli A: Cephalic stimulation of gallbladder motility. Effect of naloxone, an opioid receptor anatagonist. Ital J Gastroenterol 20:62–65, 1988

    Google Scholar 

  10. Feldman M, Walsh JH, Taylor JL: Effect of naloxone and morphine on gastric secretion and on serum gastrin and pancreatic polypeptide concentrations in human. Gastroenterology 79:294–298, 1980

    Google Scholar 

  11. Lamers CBHW, Jansen, JBMJ: The effect of a gastrinreceptor antagonist on gastric acid secretion and serum gastrin in the Zollinger-Ellison syndrome. J Clin Gastroenterol 5:21–24, 1983

    Google Scholar 

  12. Rovati LR: Inhibition of gastric secretion by anti-gastrinic and H2-blocking agents. Scand J Gastroenterol 3(Suppl 42):113–118, 1976

    Google Scholar 

  13. Dooley CP, Valenzuela JE: Duodenal volume and osmoreceptor in the stimulation of human pancreatic secretion. Gastroenterology 88:23–27, 1984

    Google Scholar 

  14. Fordtran JS, Locklear TW: Ionic constituents and osmolality of gastric and small intestinal fluids after eating. Am J Dig Dis 11:503–521, 1966

    Google Scholar 

  15. Thompson DG, Wingate DL: Effects of osmoreceptor stimulation on human duodenal motor activity. Gut 29:173–180, 1988

    Google Scholar 

  16. Matsumoto T, Sarna SK, Condon RE, Dodds WJ, Mochinaga N: Canine gallbladder cyclic motor activity. Am J Physiol 255:G409-G416, 1988

    Google Scholar 

  17. Keane FB, DiMagno E, Dozois RR, Go WLW: Relationship among canine interdigestive exocrine pancreatic and biliary flow, duodenal motor activity, plasma pancreatic polypeptide and motilin. Gastroenterology 78:310–316, 1980

    Google Scholar 

  18. Debas HT, Yamagishi T: Evidence for a pyloro-cholecystic reflex for gallbladder contraction. Ann Surg 190:170–175, 1979

    Google Scholar 

  19. Williams RD, Huang ET: The effect of vagotomy on biliary pressure. Surgery 66:353–360, 1969

    Google Scholar 

  20. Cough MJ, Humphrey CS, Giles GR: Does osmotic control of gastric emptying persist after truncal vagotomy? Br J Surg 68:77–80, 1981

    Google Scholar 

  21. Shiratori K, Watanabe S, Chey WY, Lee KY, Chang TM: Endogenous cholecystokinin drives gallbladder emptying in dogs. Am J Physiol 251:G553-G558, 1986

    Google Scholar 

  22. Niederau C, Heintgens T, Rovati L, Strohmeyer G: Effects of loxiglumide on gallbladder emptying in healthy volunteers. Gastroenterology 97:1331–1336, 1989

    Google Scholar 

  23. Worobetz LJ, Baker RJ, McCallum JA, Wells G, Sullivan SN: The effect of naloxone, morphine, and an enkephalin analogue on cholecystokinin octapeptide-stimulated gallbladder emptying. Am J Gastroenterol 77:509–511, 1982

    Google Scholar 

  24. Cai W, Gu J, Huang W, McGregor GP, Ghatei MA, Bloom SR, Polak JM: Peptide immunoreactive nerves and cells of the guinea pig gallbladder and biliary pathways. Gut 24:1186–1193, 1983

    Google Scholar 

  25. Severi C, Grider JR, Maklhouf GM: Functional gradients in muscle cells isolated from gallbladder, cystic duct, and common bile duct. Am J Physiol 255:G647-G652, 1988

    Google Scholar 

  26. Thompson DG, Richelson E, Malagelada JR: Perturbation of gastric emptying and duodenal motility via the central nervous system. Gastroenterology 83:1200–1206, 1982

    Google Scholar 

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Fiorucci, S., Bosso, R. & Morelli, A. Duodenal osmolality drives gallbladder emptying in humans. Digest Dis Sci 35, 698–704 (1990). https://doi.org/10.1007/BF01540170

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  • DOI: https://doi.org/10.1007/BF01540170

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