A stomach road or “Magenstrasse” for gastric emptying

Abstract Gastric muscle contractions grind and mix solid/liquid meal within the stomach, and move it into the bowels at a controlled rate. Contractions are of two types: slow volume-reducing contractions of the proximal stomach (the fundus), and peristaltic contraction waves in the distal stomach (t...

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Bibliographic Details
Published in:Journal of biomechanics 2007-01, Vol.40 (6), p.1202-1210
Main Authors: Pal, Anupam, Brasseur, James G, Abrahamsson, Bertil
Format: Article
Language:English
Subjects:
Algorithms
Atoms & subatomic particles
Bio-fluid mechanics
Biological Clocks - physiology
Boundary conditions
Computer Simulation
Digestive system
FARMACI
Flow velocity
Gastric emptying
Gastric Emptying - physiology
Gastric motility
Geometry
Humans
Lattice Boltzmann method
Models, Biological
Motility
Muscle, Smooth - physiology
Peristalsis - physiology
PHARMACY
Physical Medicine and Rehabilitation
Stomach
Stomach - physiology
Studies
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Summary:Abstract Gastric muscle contractions grind and mix solid/liquid meal within the stomach, and move it into the bowels at a controlled rate. Contractions are of two types: slow volume-reducing contractions of the proximal stomach (the fundus), and peristaltic contraction waves in the distal stomach (the antrum). Fundic squeeze maintains gastro-duodenal pressure difference to drive gastric emptying. Emptying is generally assumed to proceed from the antrum to the fundus, so that ingested drugs can take hours to enter the small intestines and activate. Antral contraction waves (ACW), in contrast, generate fluid motions that break down and mix gastric content. Using a computer model of the human stomach, we discover a new function of these contraction waves apart from grinding and mixing. In coordination with fundic contraction, antral contraction waves move liquid content from the fundus along a very narrow path to the duodenum through the center of the antrum. Using physiological data, we show that this gastric emptying “Magenstrasse” (stomach road) can funnel liquid gastric content from the farthest reaches of the fundus directly to the intestines within 10 min. Consequently, whereas drugs (tablets, capsules, liquid) released off the Magenstrasse may require hours to enter the duodenum, at low concentration, when released on the Magenstrasse the drug can enter the duodenum and activate within 10 min—at high concentration. This discovery might explain observed high variability in drug initiation time, and may have important implications to both drug delivery and digestion, as well as to other wall-driven emptying of elastic containers.
ISSN:0021-9290
1873-2380
1873-2380
DOI:10.1016/j.jbiomech.2006.06.006