Role of the proximal and distal stomach in mixed solid and liquid meal emptying
Open accessAbstract
The role of the proximal and distal stomach in the emptying of solids and liquids from the stomach remains unclear. We have used a dual isotope technique to quantify proximal and distal stomach emptying of a solid (100 g of 99mTc labelled liver/ground beef) liquid (either 200 ml of normal saline (eight subjects) or 25% dextrose (seven subjects) labelled with 113mIn-diethylenetriaminepenta-acetic acid) mixed meal. A manometric catheter simultaneously measured antral, pyloric, and duodenal motor activity. The liquid component dispersed rapidly throughout the stomach and emptied after a minimal lag period. The emptying of the 25% dextrose was delayed compared with the saline. This delay was associated with increased retention of the liquid in the distal stomach, a significant increase in localised phasic pyloric contractions, and a suppression of antral contractions. The solid component initially resided wholly within a proximal stomach reservoir area. Solids then redistributed from proximal to distal stomach during the emptying of liquid from the stomach. Dextrose delayed gastric emptying of solids compared with saline by increasing the solid lag period and retention in the proximal stomach. There was no significant difference between saline and dextrose meals in the distal stomach retention of solid or in the linear rate of emptying after the lag period. We conclude that, contrary to general opinion, the proximal stomach plays an important role in the control of gastric emptying of solids while the distal stomach is important in the emptying of nutrient liquids.
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Following a meal, food first stays in the fundus and is later moved in portions to the antrum.
“After meal ingestion, the food initially remains in the proximal part of the stomach (fundus) (13) and is then delivered in portions to the distal stomach (eg, antrum) (14,15).”
From Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects (2007) · cites this paper as [13]
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- Authors
- Collins, P. J., Houghton, L. A., Read, N. W., Horowitz, M., Chatterton, B. E., Heddle, R., & Dent, J.
- Affiliations
- Royal Adelaide Hospital (AU)
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1991-06
- Volume
- 32
- Issue
- 6
- Pages
- 615-619
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1378874
- OpenAlex
- W2007701360
- Cited by
- 175
- References
- 18
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 7 · 2015: 7 · 2014: 3 · 2013: 9 · 2012: 12
- FWCI
- 7.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gastric Cancer Management and Outcomes
- Keywords
- gastric emptying, proximal stomach, distal stomach, D-glucose, gastric motility, antral contractions
- MeSH terms
- Adolescent, Adult, Cardia, Female, Gastric Emptying, Glucose, Humans, Indium Radioisotopes, Male, Manometry, Middle Aged, Pressure, Pyloric Antrum, Pylorus, Technetium Tc 99m Sulfur Colloid, Time Factors
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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