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.
Similar content being viewed by others
References
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
Hunt JN: Some properties of an alimentary osmoreceptor mechanism. J Physiol 132:2677–2688, 1956
Hunt JN: The duodenal regulation of gastric emptying. Gastroenterology 43:149–156, 1963
Meerof JC, Go WLW, Phillips SD: Control of gastric emptying by duodenal contents in man. Gastroenterology 68:1144–1151, 1975
Fisher RS, Rock E, Malmud LS: Effects of meal composition on gallbladder and gastric emptying in man. Dig Dis Sci 32:1337–1344, 1987
Dodds WJ, Groth WJ, Darweesh RMA, Lawson TL, Kusher SMA, Kern MK: Sonographic measurement of gallbladder volume. Am J Radiol 145:1009–1011, 1985
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
Schiller LR, Walsh JH, Feldman M: Effect of atropine on gastrin release stimulated by aminoacid meal in humans. Gastroenterology 83:276–282, 1982
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
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
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
Rovati LR: Inhibition of gastric secretion by anti-gastrinic and H2-blocking agents. Scand J Gastroenterol 3(Suppl 42):113–118, 1976
Dooley CP, Valenzuela JE: Duodenal volume and osmoreceptor in the stimulation of human pancreatic secretion. Gastroenterology 88:23–27, 1984
Fordtran JS, Locklear TW: Ionic constituents and osmolality of gastric and small intestinal fluids after eating. Am J Dig Dis 11:503–521, 1966
Thompson DG, Wingate DL: Effects of osmoreceptor stimulation on human duodenal motor activity. Gut 29:173–180, 1988
Matsumoto T, Sarna SK, Condon RE, Dodds WJ, Mochinaga N: Canine gallbladder cyclic motor activity. Am J Physiol 255:G409-G416, 1988
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
Debas HT, Yamagishi T: Evidence for a pyloro-cholecystic reflex for gallbladder contraction. Ann Surg 190:170–175, 1979
Williams RD, Huang ET: The effect of vagotomy on biliary pressure. Surgery 66:353–360, 1969
Cough MJ, Humphrey CS, Giles GR: Does osmotic control of gastric emptying persist after truncal vagotomy? Br J Surg 68:77–80, 1981
Shiratori K, Watanabe S, Chey WY, Lee KY, Chang TM: Endogenous cholecystokinin drives gallbladder emptying in dogs. Am J Physiol 251:G553-G558, 1986
Niederau C, Heintgens T, Rovati L, Strohmeyer G: Effects of loxiglumide on gallbladder emptying in healthy volunteers. Gastroenterology 97:1331–1336, 1989
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
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
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
Thompson DG, Richelson E, Malagelada JR: Perturbation of gastric emptying and duodenal motility via the central nervous system. Gastroenterology 83:1200–1206, 1982
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
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
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01540170