Gastroduodenal motility

Significant advances were reported in several areas of gastroduodenal motility during the past 12 months. The complexity and multifactorial control of gastric emptying rate was highlighted. It seems that simultaneous analysis of the spatial and temporal characteristics of gastro-pyloro-duodenal contractions is important in fully understanding the mechanisms of regulation of gastric emptying. Cholecystokinin may play an important role in the afferent sensory pathway to inhibit gastric emptying by neurohormonal feedback from the duodenum. Very little progress was made in elucidating the etiology of dyspepsia. However, it seems that cisapride may be effective in relieving symptoms of dyspepsia at least in some patients. Erythromycin remains a potential gastro-prokinetic agent. However, like other prokinetic agents, it may not be effective in all patients with gastric stasis and the patients may become refractory after long-term use. The method of monitoring gastric function by cutaneous electrogastrogram is noninvasive and convenient, but the information it can provide is very limited. This raises serious questions about its potential as a diagnostic tool. Finally, absence of nitric oxide synthase in the enteric nerves of the pyloric circular muscle may be a factor in infantile hypertrophic pyloric stenosis.