Variations in duodenal cross-sectional area during the interdigestive migrating motility complex

Abstract

A probe for measurement of intestinal cross-sectional area (CA) was used to elucidate variations of human gut CA during the interdigestive migrating motility complex (MMC). A balloon was inflated by saline at a pressure of 1 kPa, and variations of balloon CA (BCSA) were measured by means of the field-gradient principle. Duodenal phasic activity was measured by perfused side holes proximal to, distal to, and inside the balloon. In vitro characterization of probe performance showed that static measurement of BCSA was very accurate regardless of the configuration of the balloon. However, during dynamic measurements, BCSA was valid only for slow variations in BCSA due to resistance in the evacuation and inflation system. Eight duodenal MMCs were recorded. BCSA increased consistently from the start of phase I to the end of phase II from 72 (45-100) to 136 (87-154) mm2. During late phase II, a large BCSA increase was recorded. A positive correlation between the phasic activity level in phases I and II of MMC and maximal BCSA in duodenum was demonstrated (proximal P less than 0.01; distal P less than 0.05). BCSA during phase III was small but could not be estimated accurately because steady-state conditions were not obtained. The large BCSA in late phase II suggests a relaxation of the duodenal wall secondary to a decrease in smooth muscle tone. The results add evidence to previous findings of a low-resistance or large-capacitance situation in late phase II, observed as a large pancreaticobiliary excretion into the duodenum and an increased flow of duodenal contents.