HUMAN SMALL INTESTINAL MOTILITY AND TRANSPORT--CORRELATIVE STUDIES

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Clinically, the intestine integrates transport and motility functions to provide a coordinated response to a variety of challenges. The goals of this study are 1) to determine the relationship between intestinal epithelial transport and motility by measuring parameters simultaneously in normal volunteers, and 2) to determine the feasibility of cable analysis to measure electrical resistance, a surrogate for permeability, in the intestine. To accomplish this, the investigators designed a tube to measure small bowel motility (pressure) and transport. In the volunteers enrolled, we have demonstrated the feasibility of these simultaneous measurements of motility and electrogenic transport. Increasing concentrations of glucose elicit an increasing potential difference signal. Motility patterns are consistent with the three phases of the migrating motor complex. Interestingly, direct installation of glucose into the jejunum does not cause reversion to a fed pattern. Because of cholinergic side effects in one patient, we have decided to stop using acetyl choline as a secretory stimulus and will now use prostaglandin analogues.