Role of cholecystokinin in relaxation of the proximal stomach

• Published in: Scandinavian journal of gastroenterology Vol. 36; no. 4; p. 361
• Main Authors: van der Schaar, P J, Bremer, Y, Lamers, C B, Masclee, A A
• Format: Journal Article
• Language: English
• Published: England 01.01.2001
• Subjects: Adult; Cholecystokinin - administration & dosage; Cholecystokinin - metabolism; Dietary Carbohydrates - administration & dosage; Dietary Fats - administration & dosage; Digestion - drug effects; Digestion - physiology; Female; Gastrointestinal Motility - physiology; Humans; Injections, Intravenous; Male; Manometry; Multivariate Analysis; Muscle Relaxation - physiology; Postprandial Period - physiology; Probability; Reference Values; Sensitivity and Specificity; Stomach - drug effects; Stomach - physiology
• ISSN: 0036-5521
• DOI: 10.1080/00365520119867

Ingestion of a meal causes proximal gastric relaxation (accommodation). The magnitude of accommodation is related to the fat content of the meal. A role for cholecystokinin (CCK) has been suggested. However, under fasting conditions intravenous CCK to postprandial levels does not induce a similar accommodation. This study further explores the role of CCK in accommodation. A gastric barostat was used in eight healthy persons to study accommodation in response to a carbohydrate meal with intravenous CCK (CH-CCK), carbohydrate meal with intravenous placebo (CH-placebo) and a fat rich meal with intravenous placebo (FAT). VAS scores for satiety and plasma CCK levels were obtained. In the first postprandial hour the FAT meal induced a relaxation of 112 +/- 29 ml, the CH-CCK meal 49 +/- 36 ml and the CH-placebo meal 12 +/- 32 ml (FAT versus CH-placebo P = 0.03; FAT versus CH-CCK P = 0.09). In the second postprandial hour, intragastric bag volume returned to baseline with all meals. The FAT meal had the most pronounced effect with respect to satiety, CH-placebo the least. In the first postprandial hour, plasma CCK levels increased with the CH-CCK and FAT meals but not with the CH-placebo meal; in the second postprandial hour, levels remained elevated with the CH-CCK meal. It is concluded that a carbohydrate meal with exogenous CCK does not induce fundic relaxation, whereas a fat-rich meal (endogenous CCK) does, despite similar plasma CCK levels.