Antropyloroduodenal motor responses to intraduodenal lipid infusion in healthy volunteers

The delivery of lipid to the duodenum has been shown to slow gastric emptying and to increase the resistance to gastric outflow. To investigate mechanisms responsible for these effects, we have recorded antropyloroduodenal motility in nine healthy volunteers during alternate intraduodenal infusions of normal saline and triglyceride emulsion (Intralipid 10%). During the lipid infusions there were reproducible, major changes in the patterns of motility. Pressure waves, apparently isolated to the pylorous, usually started within 10 min of initiation of the lipid infusion. After 20-25 min of lipid infusion these waves occurred at median rates of 2.4 and 2.8./min (1st and 2nd lipid infusions, respectively); these rates were significantly greater (P < 0.05) than the median rates (all ≤ 0.4/min) observed during the equivalent period of the succeeding saline infusion. During 10 of 22 lipid infusions, isolated pyloric pressure waves were associated with sustained pyloric tone. Infusion of lipid into the duodenum suppressed antral pressure waves in all subjects and initiated brief periods of regular duodenal contractions during 11 of 22 infusion. These studies have demonstrated alterations of antropyloroduodenal motor patterns in response to changes in the duodenal luminal content. The effects on antral and pyloric motility are probably of importance in the regulation of transpyloric flow by nutrients in the duodenal lumen.