Potentially functional lactose-free ice cream with Lacticaseibacillus casei CSL3, ginger, and honey.

AIMS: To develop and characterize a functional lactose-free ice cream with added ginger and honey, evaluate the survival of Lacticaseibacillus casei CSL3 under frozen storage and the simulated gastrointestinal tract (GIT), as well as antioxidant activity and product acceptability. METHODS AND RESULTS: The survival of Lacticaseibacillus casei CSL3 was evaluated for 180 days, under frozen storage, and GIT at 60 days. At 15 days of storage, proximal composition, antioxidant activity, color, pH, acidity, fusion, density, overrun, and sensory analysis were performed. Ice cream was an effective food matrix for maintaining the viability of CSL3, with concentrations > 7 log CFU g- 1 during storage and GIT. In addition, the analysis showed overrun and prebiotic characteristics through high values of antioxidant activity and phenolic compounds, good acceptability, and purchase intention. CONCLUSIONS: The product has satisfactory market potential (acceptance rate of 95.19% and purchase intention rate > 96%), and it could become another means of inserting probiotics in food.

Nandrolone decanoate impairs gastrointestinal motility and duodenal morphometry in moderately exercised rats

The misuse of anabolic androgenic steroid associated or not with physical workouts disrupts gastrointestinal (GI) function homeostasis. Our goal was to investigate the effects of nandrolone decanoate (ND) and moderate swimming on the GI transit of solid meals, GI motor contractility, and intestinal histology in rats. Male Wistar rats were allocated to four groups that received intramuscular injections of ND (5.0 mg/kg) or vehicle (60.0 µL) and were submitted or not to swimming sessions (60 min, 5% body weight overload) for 4 weeks. Gastric emptying, intestinal transit, in vitro GI contractility, intestinal morphometry, and duodenal mucosal mast cells were evaluated in all experimental groups. ND treatment accelerated gastric emptying, slowed small intestine transit time, enhanced gastric carbachol-mediated reactivity, decreased crypt depth and villus height, reduced mucosal thickness, and increased the circular and longitudinal muscle layer thickness of the duodenum in sedentary rats. Moderate exercise accelerated intestinal transit time and reduced submucosa thickness. In vehicle-treated animals, a strong negative correlation was found between intestinal transit and mucosal mast cells, which was reversed by ND treatment. Combining ND treatment and swimming accelerated gastric emptying, increased duodenal cholinergic reactivity, inhibited the sodium nitroprusside relaxing response, increased the number of duodenal mast cells, decreased villus height, and increased the thickness of all muscle layers. ND changed the morphological and functional properties of the GI tract over time, with intense dysmotility, especially in sedentary animals, but moderate exercise seemed to have played a compensatory role in these harmful effects in the gut.

Non-invasive biomagnetic assessment of gastrointestinal motility in a loperamide-induced constipation model

Constipation is a disorder of the gastrointestinal (GI) and some of the main etiological mechanisms are directly related to changes in GI physiology. The capacity to carry out paired assessments and measure GI parameters under the influence of constipation is a relevant point in selecting a suitable methodology. We aimed to perform a non-invasive investigation of gastrointestinal motility in constipated rats using the alternating current biosusceptometry system (ACB). The animals were split into two groups: the pre-induction stage (CONTROL) and post-induction loperamide stage (LOP). We assessed GI motility parameters using the ACB system. Colon morphometric and immunohistochemical analyses were performed for biomarkers (C-kit) for interstitial cells of Cajal (ICC). Our results showed a significant increase in gastrointestinal transit in the LOP group in addition to a reduction in the dominant frequency of gastric contraction and an arrhythmic profile. A change in colonic contractility profiles was observed, indicating colonic dysmotility in the LOP group. We found a reduction in the number of biomarkers for intestinal cells of Cajal (ICC) in the LOP group. The ACB system can evaluate transit irregularities and their degrees of severity, while also supporting research into novel, safer, and more efficient treatments for constipation.

Alternate-day fasting induces metabolic and morphofunctional changes in the gastrointestinal tract of male rats.

Alternate-day fasting (ADF) is a nutritional intervention with modulatory and overall protective effects, but its role in the gastrointestinal (GI) tract is still uncertain. The aim of this study was to investigate the influence of ADF on the metabolic patterns and morphofunctional motility of the GI tract in rats. Thirty-two male Wistar rats were allocated into groups: control for 15 days (CON 15, n = 8), control for 30 days (CON 30, n = 8), ADF for 15 days (ADF 15, n = 8), and ADF for 30 days (ADF 30, n = 8). Blood glucose, body weight, and food and water consumption were measured. Frequency and amplitude of gastric contractions as well as gastric emptying time, small intestinal transit time, and cecum arrival time were measured. Intestinal histomorphometric, relative weight of organs, lipidogram, and leptin levels were also evaluated. ADF decreased water consumption and food consumption. The weight gain decreased; however, the relative kidney weight increased. ADF triggered an increase in the amplitude of gastric contractions and accelerated gastric emptying. However, small intestinal transit time was delayed in both ADF groups. Total cholesterol, triglycerides, non-HDL cholesterol, and very low-density lipoprotein cholesterol levels decreased, whereas villus height, depth of the crypts and thickness of the circular, and longitudinal muscular layers of intestine increased after ADF. In conclusion, our results showed ADF exert an effect on both metabolism and GI motility and impacts on overall digestive functions.

Heno de alfalfa en la dieta final para emús: rendimiento, producción de canal y alometría gastrointestinal

RESUMEN Objetivo. Se determinaron los resultados de la inclusión de heno de alfalfa en la dieta de los emús, como ensayo simple para analizar la práctica de campo de su uso como fuente de forraje similar a otras dietas de ratitas. Materiales y métodos. Los tratamientos consistieron en dos dietas, sin (dieta 1) o con (dieta 2) inclusión de heno de alfalfa. Veinte emús, con 38.4 semanas de edad media, se distribuyeron en los dos tratamientos y se alojaron en un sistema semiintensivo con alimentación y agua ad libitum. El peso corporal se evaluó semanalmente durante 13 semanas. Tras 91 días de ensayo, los emús fueron sacrificados y se midió el rendimiento de la canal y la alometría gastrointestinal. Resultados. La ganancia de peso acumulada fue menor (p<0.05) con la ingesta de la dieta 2 que con la dieta 1, 2.12 y 2.08 kg, a las 11 y 12 semanas del inicio del ensayo, respectivamente. Además, la deposición de grasa abdominal y visceral en los emús alimentados con la dieta 2 fue un 0.77 y un 0.63% menor (p<0.05), respectivamente. La inclusión de heno de alfalfa aumentó el peso relativo de la molleja y el intestino (p<0.05) y la longitud relativa del intestino (p<0.05), sin embargo, la alometría del ciego no se vio afectada (p>0.05). Conclusiones. El heno de alfalfa puede comprometer negativamente el crecimiento y la deposición de grasa de los emús cuando se añade a la alimentación de los finalizadores, y alterar la alometría del tracto gastrointestinal.

ABSTRACT Objective. The results of the inclusion of alfalfa hay on emus diet were determined, as a plain trial to analyze the field practice of using it as a roughage source similar to other ratites diets. Materials and methods. The treatments consisted of two diets, without (diet 1) or with (diet 2) alfalfa hay inclusion. Twenty emus, with 38.4 weeks of mean age, were distributed in two treatments and housed in a semi-intensive system with ad libitum feed and water. The body weight was assessed weekly over 13 weeks. After 91 days of trial, the emus were slaughtered and the carcass yield and gastrointestinal allometry were measured. Results. Cumulative weight gain was lower (p<0.05) by intake diet 2 than diet 1, 2.12 and 2.08 kg, at 11 and 12 weeks after the start of the trial, respectively. Further, abdominal and visceral fat deposition in the emus fed with diet 2 was 0.77 and 0.63% lower (p<0.05), respectively. The inclusion of alfalfa hay increased gizzard and intestine relative weight (p<0.05) and intestine relative length (p<0.05), however, cecum allometry wasn't affected (p>0.05). Conclusions. Alfalfa hay can negatively compromise the growth and fat deposition of emus when it is added to the finisher feed, and alter the allometry of the gastrointestinal tract.

Qual é a influência da microbiota na obesidade e em seu quadro inflamatório? / What is the influence of microbiota on obesity and its inflammatory involvement?

A obesidade tem causa multifatorial que atinge atualmente mais da metade da população brasileira. Mais recentemente, a microbiota intestinal foi considerada um fator que contribui para essa condição. Os objetivos deste estudo foram revisar a influência da microbiota intestinal na obesidade e no processo inflamatório, e analisar os efeitos da utilização dos pré e probióticos. Foi realizada revisão sistemática sobre o assunto. Dos mais de 27.000 artigos, apenas 16 respeitaram os critérios de inclusão. Em conclusão, o desequilíbrio da microbiota aparece como fator favorável ao desenvolvimento da obesidade e do quadro inflamatório decorrente dela. Tanto o uso de prebióticos quanto probióticos são recursos válidos no tratamento da obesidade, porém os primeiros parecem proporcionar melhor qualidade de vida.

Obesity has a multifactorial etiological condition that involves more than half of the Brazilian population. More recently, the intestinal microbiota was considered a factor that contributes to this condition. The aims of this study were to review the intestinal microbiota influence in the obesity and in the inflammatory response, and to analyze the effects of using prebiotic and probiotic medications. A systematic review was firstly done. More than 27,000 articles were found, but only 16 contained the proper criteria. In conclusion, the microbiota imbalance seems to increase the obesity development and its inflammatory aspects. Both the use of pre and probiotics are good options in the obesity treatment, though the first ones seem to enhance bettere quality of life.

Differential effects of ß-methylphenylethylamine and octopamine on contractile parameters of the rat gastrointestinal tract.

This study tested the effects of ß-methylphenylethylamine (ß-MPEA) and octopamine on contractile parameters of the gastrointestinal tract in rats. We hypothesized that some of their effects result from interactions with trace amine (TA)-associated receptors or serotoninergic 5-hydroxytryptamine (5-HT) receptors. ß-MPEA-induced contractions in rat gastric fundus strips under resting tonus conditions, but induced relaxation in preparations that were previously contracted with carbachol. Octopamine relaxed gastric fundus strips maintained at resting tonus or contracted with carbachol. The contractile effect of ß-MPEA was reduced by cyproheptadine and methiothepin, antagonists of excitatory 5-HT receptors. The relaxing effect of ß-MPEA on gastric fundus was insensitive to pretreatment with N-(3-ethoxyphenyl)-4-(1-pyrrolidinyl)-3-(trifluoromethyl)benzamide (EPPTB) and tropisetron, antagonists of TA1 and 5-HT4 receptors, respectively. Both EPPTB and tropisetron inhibited the relaxant effects of octopamine on carbachol-contracted preparations. Contrarily, EPPTB did not reduce the relaxant effects of RO5263397 (TA1 agonist) or zacopride (5-HT4 agonist). Octopamine, but not ß-MPEA, delayed the gastrointestinal transit of a liquid test meal in awaken rats. In isolated preparations of the small intestine under resting conditions, ß-MPEA did not alter the basal tonus, but octopamine relaxed it. Intestinal preparations previously contracted with carbachol relaxed after the addition of octopamine and decreased the magnitude of their spontaneous rhythmic contractions in a tropisetron-dependent manner. Thus, ß-MPEA and octopamine exerted pharmacological actions on the rat gastrointestinal tract. The excitatory effects of ß-MPEA involved 5-HT receptors. Octopamine inhibited the rat gut contractility through the likely involvement of 5-HT4 and TA receptors. Overall, octopamine effectively inhibited rat gastrointestinal transit.

The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation / O real impacto do tempo de trânsito cólico e da manometria anorretal no diagnóstico de pacientes adultos com constipação crônica

Abstract Introduction: Anorectal physiology tests are indicated for patients who have refractory symptoms of constipation, but the best sequence of investigation remains controversial. Objective: To evaluate the influence of colonic transit time and anorectal manometry in the diagnosis of chronic constipation in adults. Method: This was a study of adult patients with constipation at a private clinic in a city in southern Brazil, from January 1, 2009 to December 31, 2018. Those who showed warning signs were referred for colonoscopy and those with any anatomical alterations were excluded. The patients received 10 g of psyllium and those who remained symptomatic after three weeks were referred for functional assessment with colonic transit time (CTT). Those who presented outlet obstruction in the colonic transit time were referred to anorectal manometry. Results: Of the 889 adult patients surveyed, 227 were included. Of the 216 who completed the study, 167 responded to primary treatment. Forty-nine underwent CTT. In these, 16 had normal colonic transit time and 33 were altered. In those with altered colonic transit time, eight had a pattern of colonic inertia and 25 had an obstruction pattern. The 25 patients with an outlet obstruction pattern underwent anorectal manometry. Eighteen had signs of paradoxical contracture of the puborectal muscle (PPRC) and seven did not. Conclusion: This study concluded that anorectal physiology exams contribute to the diagnosis of constipation, often changing the behavior. These exams should be performed whenever the patient does not respond to hygienic changes and fiber replacement.

Resumo Introdução: Os exames de fisiologia anorretal estão indicados nos pacientes que mantém sintomas refratários de constipação, porém uma sequência desejada de investigação permanece contraditória. Objetivo: Avaliar a influência do tempo de trânsito colônico e da manometria anorretal no diagnóstico da constipação crônica de adultos. Método: Estudamos os pacientes adultos de uma clínica privada em uma cidade do sul do Brasil, no período de 01 de Janeiro de 2009 a 31 de Dezembro de 2018 apresentando constipação. Aqueles que apresentassem sinais de alerta, eram encaminhados a colonoscopia e com qualquer alteração anatômica eram excluídos. Foram prescritos 10 g de Psyllium e aqueles que permaneceram sintomáticos após três semanas foram encaminhados à avaliação funcional com tempo de trânsito colônico (TTC). Os que apresentavam obstrução de saída ao tempo de trânsito colônico foram encaminhados a manometria anorretal. Resultados: Dos 889 pacientes adultos levantados, 227 foram incluídos. Dos 216 que concluíram o estudo, 167 responderam ao tratamento primário. Quarenta e nove realizaram TTC. Nestes, 16 tiveram tempo de trânsito colônico normal e 33 alterado. Naqueles com tempo de trânsito colônico alterado: oito tinham padrão de inércia colônica e 25, padrão de obstrução de saída. Os 25 pacientes com padrão de obstrução de saída foram submetidos à manometria anorretal. Dezoito tinham sinais de Contratura Paradoxal do músculo Puborretal (CPPR) e sete não. Conclusão: Concluímos que os exames de fisiologia anorretal contribuem para o diagnóstico da constipação, muitas vezes alterando a conduta. Estes exames devem ser realizados sempre que o paciente não responder as alterações higienodietéticas e a reposição de fibras.

Gastrointestinal motility and morphology in mice: Strain-dependent differences.

BACKGROUND: BALB/c and C57BL/6 mice are widely used in biomedical research; however, the differences between strains are still underestimated. Our aims were to develop an experimental protocol to evaluate the duodenal contractility and gastrointestinal transit in mice using the Alternating Current Biosusceptometry (ACB) technique and to compare gastrointestinal motor function and morphology between BALB/c and C57BL/6 strains. METHODS: Male mice were used in experiments (a) duodenal contractility: animals which had a magnetic marker surgically fixed in the duodenum to determine the frequency and amplitude of contractions and (b) gastrointestinal transit: animals which ingested a magnetically marked chow to calculate the Oro-Anal Transit Time (OATT) and the Fecal Pellet Elimination Rate (FPER). The animals were killed after the experiments for organ collection and morphometric analysis. KEY RESULTS: BALB/c and C57BL/6 had two different duodenal frequencies (high and low) with similar amplitudes. After 10 hours of monitoring, BALB/c eliminated around 89% of the ingested marker and C57BL/6 eliminated 33%; OATT and FPER were slower for C57BL/6 compared with BALB/c. The OATT and amplitude of low frequency had a strong positive correlation in C57BL/6. For BALB/c, the gastric muscular layer was thicker compared to that measured for C57BL/6. CONCLUSIONS AND INFERENCES: The experimental protocol to evaluate duodenal contractility and fecal magnetic pellets output using the ACB technique in mice was successfully established. BALB/c strains had higher duodenal frequencies and a shorter time to eliminate the ingested marker. Our results showed differences in both motor function and gastrointestinal morphology between BALB/c and C57BL/6 strains.

Antidiarrheal activity of farnesol in rodents: Pharmacological actions and molecular docking.

Diarrhea is a condition in which the individual has about three or more daily bowel movements, followed by changes in stool consistency. It is currently considered as one of the worst public health problems due to the number of cases and deaths involved and difficulty of treatment. Thus, the use of natural products is an alternative for new treatments. Among these possibilities is Farnesol (C15H26O), a sesquiterpene found in different herbal species that has known biological activities. The objective of this study was to evaluate the antidiarrheal activity of Farnesol (FOH). Initially, FOH activity was evaluated in models of diarrhea and enteropooling induced by castor oil and PGE2. To evaluate motility, the opioid and cholinergic pathways were studied. In addition, the effect of FOH was investigated in the secretion model in intestinal loops treated with cholera toxin. FOH was evaluated for the ability to absorb fluids in intestinal loops and interact with GM1 receptors using the ELISA method and molecular docking. The dose of 50 mg/kg of FOH showed the best results in all antidiarrheal activity tests with castor oil and PGE2, being considered as the standard dose, reducing motility by anticholinergic mechanisms. There was a reduction in fluid secretion when FOH interacted directly with GM1 receptors; cholera toxin and molecular docking showed strong interaction between farnesol and these targets. In view of the results presented, the antidiarrheal activity occurs through anticholinergic, anti-inflammatory and anti-secretory action, making farnesol a potential candidate for the development of a new drug to treat diarrheal diseases.

Gastrointestinal effects of ivermectin treatment in rats infected with Strongyloides venezuelensis.

We aimed to evaluate the effects of ivermectin treatment on gastrointestinal morphology and function after Strongyloides venezuelensis infection. Male rats composed Control (C), Parasitized (Sv), Ivermectin (IVM) and Parasitized and treated with Ivermectin (Sv/IVM) groups. IVM and Sv/IVM groups were subdivided according to IVM: single dose of 200 µg/kg (IVM1 and Sv/IVM1) or three repeated doses of 200 µg/kg at 24 h intervals (IVM3 and Sv/IVM3). First dose of IVM was administered after peak of infection. Eggs per gram (EPG), mean gastric emptying time (MGET), mean cecum arrival time (MCAT) and mean small intestinal transit time (MSITT) were evaluated. Measurements were performed before drug and at peak of infection, first day post peak of infection and 30 days post infection. Same time intervals were simulated for uninfected animals. Number of recovered worms and intestinal morphometry were also rated. Data were analyzed by ANOVA and correlated by Dunnett and Pearson (p < 0.05). Sv/IVM1 and Sv/IVM3 showed reduction of EPG and worms, although only group SV/IVM3 eradicate them. Hastened gastric emptying and slowed intestinal transit provoked by S. venezuelensis infection can be reverted by a single administration of IVM after peak of infection, even without total parasite elimination. Although three consecutive doses of IVM were more efficient to eradicate the parasite, drug administration impaired gastrointestinal function and morphology. IVM alone affected gastrointestinal parameters in uninfected animals for prolonged periods, especially in high doses. In control, there were strong negative correlations between MSITT and muscle layers. Strongyloides venezuelensis infection abolishes such correlations. Longitudinal muscle was thinner in IVM3 and Sv/IVM3 groups and circular thicker in Sv group. Revisiting the action of traditional drugs broadens knowledge in the parasite-host interface and may result in the development of more accurate therapeutic strategies.

Bipartición de tránsito intestinal, la nueva era de la cirugía metabólica para la diabetes mellitus de tipo 2 / Intestinal transit bipartition, the new era in metabolic surgery for type 2 diabetes

Antecedentes. La diabetes mellitus de tipo 2 es el principal reto de salud pública que enfrentamos actualmente, constituye la primera causa de discapacidad y es o está asociada a las principales causas de muerte en nuestro país. En Ciudad de México, se reportó que más del 79 % de los pacientes diabéticos no tienen cifras óptimas de HbA1c (<6,5 %), mientras que el 47 % presentan descontrol importante (HbA1c >9 %). La cirugía metabólica es el mejor tratamiento en términos de remisión, sin embargo, los mecanismos involucrados no son los tradicionalmente considerados. Objetivo. Ofrecer actualización acerca de los mecanismos involucrados en la remisión de la diabetes mellitus de tipo 2 después de la cirugía metabólica. Metodos. Se hizo una revisión bibliográfica utilizando las palabras clave en términos MeSH; hasta el 1° de junio del 2018, se encontraron 83 artículos de referencia considerados como pertinentes. Resultados. La remisión de la diabetes mellitus de tipo 2 lograda por procedimientos quirúrgicos, depende de complejas interacciones entre la microbiota, los ácidos biliares y el epitelio intestinal, más que de procesos malabsortivos o restrictivos. La bipartición de tránsito intestinal es una opción quirúrgica basada en los principios fisiológicos responsables en la remisión de la diabetes, y es la más sencilla y segura para el manejo de la diabetes mellitus. Conclusiones. La cirugía metabólica ofrece mejores tasas de remisión y control de complicaciones de la diabetes tipo 2 al modificar la secreción de enterohormonas, la concentración e interacciones de los ácidos biliares y al modificar la microbiota

Background: Diabetes mellitus type 2 (DM2) is a major public health challenge that we face today; it is the first cause of disability and is associated with the main causes of death in our country. In Mexico City, it was reported that more than 79% of diabetic patients did not have optimal levels of HbA1c (<6.5%), while 47% are not properly controlled (HbA1c> 9%). Metabolic surgery is the best treatment option for DM2, yet the presumed involved mechanisms are not traditionally considered. Objective: To provide an update on the mechanisms involved in the remission of DM2 following metabolic surgery. Methods: Narrative review of the literature, using MeSH terms, until June 1, 2018, encountering 83 articles considered pertinent. Methods: Narrative review of the literature, using MeSH terms, until June 1, 2018, encountering 83 articles considered pertinent. Results: DM2 remission after surgery depends on complex interactions between the microbiota, biliary acids and the intestinal epithelium, more so than of malabsortion or restrictive processes. Bipartition of the intestinal transit constitutes a surgical option based on the physiologic principles responsible of the remission of diabetes, and it is a simple and most secure procedure for the management of diabetes. Mechanisms include restoration/ enhancement of incretin secretion; as well as an improvement of bile acid concentration and microbiome manipulation, rather than the commonly accepted restriction and malabsorption. Intestinal transit bipartition is a novel and simple procedure that complies with the actual involved mechanisms, with comparable results in terms of safety and efficacy with the more complex and demanding techniques, such as the gastric bypass. Conclusions: Metabolic surgery is the best treatment for DM2 in terms of remission and prevention of complications, modifying the secretion of enterohormones, the concentration of biliary acids, and the modification of the microbiota

Beet pulp intake and hairball faecal excretion in mixed-breed shorthaired cats.

Hairball formation may induce vomiting and intestinal obstruction in predisposed cats. Some insoluble fibres as sugarcane fibre and cellulose can prevent hairball formation. The aim of this study was to evaluate the effect of beet pulp consumption, a moderate soluble and fermentable fibre source, on faecal trichobezoars excretion in adult shorthaired cats fed kibble diets. Eighteen mixed-breed shorthaired cats and three extruded diets were used as follows: a basal diet without added fibre source (PB0-8.8% dietary fibre); BP8-8% inclusion of beet pulp (17.5% of dietary fibre); BP16-16% inclusion of beet pulp (23.8% of dietary fibre). The cats were fed during 31 days and faeces quantitatively collected during three periods of 3 days each (from days 3-5; 15-17; 26-28). Gastrointestinal transit time was determined in the last 3 days of study (from days 29-31). The trichobezoars were separated from faeces, collected, dried and washed in ether for complete removal of all faecal material. The results were submitted to repeated-measure analysis of variance and means evaluated by polynomial contrast (p < 0.05). Beet pulp increased faecal production (p < 0.001) and reduced gastrointestinal transit time (p = 0.003). No alterations were found on trichobezoar faecal excretion, both as considered in number per cat per day of mg per cat per day (p > 0.05). Beet pulp intake did not reduce the number or the size of hairballs eliminated via faeces of shorthaired cats.

Colonic Inertia: approach and treatment / Inércia Cólica: abordagem e tratamento

ABSTRACT Objective: Revision of the state of the art of the knowledge regarding pathophysiology, diagnosis and treatment of Colonic Inertia, which predominantly affects young women and has a significant socio-economic impact. Methods: A search was made in “colonic inertia”, “colon inertia” and “slow transit constipation” in PubMed database for articles of the last 5 years, in Portuguese or English with available abstract and full text. 59 articles and 2013 guidelines of the American Gastroenterological Association on constipation were included. Results: The pathophysiology is not completely elucidated and the reduction of the interstitial cells of Cajal is the most consistent histological finding. Diagnosis requires the exclusion of secondary causes of constipation and obstructed defecation syndrome, to which contribute several complementary diagnostic tests. Given the frequency of failure of the medical treatment, surgery is often the only possible option. Sacral nerve stimulation seems to be a promising therapeutical alternative. Conclusion: A deeper investigation of the pathophysiological mechanisms is fundamental to acquire a more global and integrated vision. Rigorous patient selection for each treatment and the discovery of new therapeutical targets may avoid the use of surgical therapies.

RESUMO Objetivo: Revisão do estado da arte do conhecimento da patofisiologia, diagnóstico e tratamento da Inércia Cólica, que afeta predominantemente mulheres jovens e tem um impacto socioeconómico significativo. Métodos: Pesquisou-se na base de dados PubMed por “colonic inertia”, “colon inertia” e “slow transit constipation” por artigos apenas dos últimos 5 anos, em português ou em inglês com resumo e texto completo disponíveis. Incluíram-se 59 artigos e as recomendações de 2013 da Associação Americana de Gastroenterologia para a obstipação. Resultados: A patofisiologia ainda não está completamente esclarecida, sendo que a redução das células intersticiais de Cajal constitui o achado histológico mais consistente. O diagnóstico requer a exclusão de causas secundárias de obstipação e de síndrome de obstrução defecatória, para o qual contribuem vários exames complementares de diagnóstico. Dada a frequência do insucesso do tratamento médico, a cirurgia é, muitas vezes, a única opção possível. A estimulação nervosa sagrada parece ser uma alternativa terapêutica promissora. Conclusão: É fundamental uma investigação mais profunda dos mecanismos patofisiológicos envolvidos para adquirir uma visão mais global e integrada. A seleção rigorosa de pacientes para cada tratamento e a descoberta de novos alvos terapêuticos poderão evitar a utilização de terapêuticas cirúrgicas.

Effects of antipsychotics on intestinal motility in zebrafish larvae.

BACKGROUND: Antipsychotics are essential for the treatment of schizophrenia. However, due to side effects, both continuity of treatment and patients' general health can be jeopardized. Some of these drugs, especially clozapine, have a class of side effects attributed to their antimuscarinic properties, such as dysmotility, a condition in which muscles of the digestive system become impaired. Dysmotility may also alter the speed, strength or coordination of the digestive organs, causing distention, disturbing gastrointestinal transit, leading to symptoms such as bloating, nausea, vomiting, and even malnutrition. In this study, our aim was to develop an in vivo assay capable of identifying and studying the antimuscarinic effects of antipsychotics in a zebrafish model. METHODS: We performed video recordings of in vivo 5-day postfertilization (dpf) zebrafish larvae gastrointestinal tracts and analyzed the frequency of spontaneous and regular cycles of contractions of the gut. KEY RESULTS: The assay was first validated with treatment with atropine. We showed that this antimuscarinic drug reduces peristaltic cycles. Subsequently, the larvae were treated with the antipsychotics haloperidol, risperidone, and clozapine. Neither haloperidol nor risperidone reduced gut motility, but clozapine significantly reduced the frequency of cycles of contractions (P<.0001), which confirms the existing clinical data. CONCLUSIONS & INFERENCES: We conclude that this zebrafish assay efficiently identifies anticholinergic side effects of antipsychotics, and can thus be a quick and useful way to screen for this property in new drugs.

Insoluble fibres, satiety and food intake in cats fed kibble diets.

Fibre is generally considered to dilute food energy, alter intestinal transit time and promote satiety; however, in cats, conflicting results have been found. In this study, two insoluble fibres were evaluated in four feline diets: control (no added fibre); diet with 10% sugar cane fibre; diet with 20% sugar cane fibre; and diet with 10% cellulose. The experiment was conducted with 32 cats, eight animals per diet, over 42 days: 1-7 for diet adaptation; 8-14 for total collection of faeces for digestibility; 15-17 for fresh faeces collection for fermentation products measurements; 18-20 for gastrointestinal transit time determination; 21 and 37 to evaluate the pattern of food intake; and 22 and 42 to assess satiety. Means were compared by analysis of variance and orthogonal contrasts, and the pattern of food intake was compared by repeated-measures analysis of variance (p < 0.05). The cats exhibited increased food intake after fibre addition to the diets (p < 0.05), achieving similar energy consumption. Cellulose and the two levels of sugar cane fibre reduced nutrient availability and energy digestibility, but only sugar cane fibre reduced fat digestibility (p < 0.05). Faecal output and the number of defecations per day increased with fibre inclusion (p < 0.05). Gastrointestinal transit time did not change with sugar cane fibre inclusion, but it was reduced with cellulose addition (p = 0.032). The pattern of food intake did not change, but cats fed fibre-supplemented diets exhibited greater consumption of a challenge meal, increasing energy intake (p < 0.01) when exposed to a palatable, energy-dense food.

Sex and Food Influence on Intestinal Absorption of Ketoprofen Gastroresistant Formulation.

Sixteen healthy volunteers (8 women and 8 men) participated in a 2-period, 2-treatment crossover study. A delayed-release gastroresistant formulation of ketoprofen was administered under fasting and fed conditions. Cmax , AUC, Cmax /AUC, and kel obtained after food coadministration did not differ from those calculated under fasting administration. Ninety-five percent confidence intervals for fed/fasting geometric mean ratio of Cmax /AUC and AUC were 0.80-1.14 and 0.80-1.23, respectively. A significant difference (P < .01) was found between lag-time medians (T0 ), with a longer T0 after food intake (5.5 vs 2.5 hours). Also, a significant difference between the medians of Tmax was found (P < .01), being 7.0 hours after food coadministration and 4.0 hours under fasting administration, but this difference disappeared once T0 was subtracted from Tmax . Cmax /AUC, which is related to drug absorption rate, showed significant differences between sexes. Men showed higher (P =.006) Cmax /AUC means (0.468 ± 0.094 vs 0.361 ± 0.087 h(-1) . Tmax was also significantly different (P < .05), being 4.0 (3.0-5.0) hours for men and 8.0 (5.0-10.0) hours for women. In conclusion, men showed a faster intestinal absorption rate with earlier time-to-peak plasma concentration of ketoprofen. Food coadministration extended the gastric residence time of formulation but exerted no effect on its intestinal absorption pattern.

[Outcomes, controversies and gastric volume after laparoscopic sleeve gastrectomy in the treatment of obesity]. / Resultados, controversias, y volumen gástrico después de la gastrectomía vertical laparoscópica en el tratamiento de la obesidad.

BACKGROUND: Laparoscopic sleeve gastrectomy is a surgical procedure for the treatment of morbid obesity. However, there are still controversies regarding its efficiency in terms of weight reduction and incidence of complications. In this prospective study, the experience is presented of a referral centre for the treatment of morbid obesity with laparoscopic sleeve gastrectomy. MATERIAL AND METHODS: A prospective study on 73 patients subjected to laparoscopic sleeve gastrectomy from February 2009 to September 2013. Patients were followed-up for a period of 12 months, evaluating the development of complications, reduction of gastric volume, and the weight loss associated with the surgery, as well as their impact on the improvement of comorbidities present at beginning of the study. RESULTS: There was a statistically a significantly reduction between the preoperative body mass index (BMI) and the BMI at 12 months after laparoscopic sleeve gastrectomy (p < 0.001), despite there being an increase in the gastric volume during follow-up, measured at one month and 12 months after surgery (p < 0.001). Five patients (6.85%) had complications, with none of them serious and with no deaths in the whole series. CONCLUSIONS: Laparoscopic sleeve gastrectomy is a safe and effective technique for the treatment of morbid obesity. Its use is associated with a significant reduction in the presence of comorbidities associated with obesity. Multicentre studies with a longer period of monitoring are required to confirm the efficacy and safety of this surgical technique.

Evaluation of gastrointestinal transit after infection with different loads of Strongyloides venezuelensis in rats.

The aim was to correlate the gastrointestinal transit profile in rats, evaluated by a biomagnetic technique, in response to infection with different loads of Strongyloides venezuelensis. Eggs per gram, intestinal number of worms and fecundity, and also gastric emptying time, cecum arrival time, small intestinal transit time and stool weight were determined. Assessments occurred at 0 (control), 3, 6, 9, 12, 15, 18 and 21 days post infection (dpi) with three infective loads (400, 2000, and 10,000 L). Gastric emptying was faster (p=0.0001) and the intestinal transit was significantly slower (p=0.001) during the infection time course. Also, linear mixed-effects models showed significantly changes in small intestinal transit after three parasite load over time. Cecum arrival was not influenced by infection time course or parasite load. As indirect effect, stool weight decreased accompanied a strong oviposition peak at 9 dpi in 400 L and 2000 L. In several motor function instances, neuromuscular dysfunction persists after mucosal inflammation has decreased. Our approach could be very helpful to evaluate gastrointestinal motor abnormalities in vivo after parasite infection. Despite parasitological data progressively decreased after 15 dpi, small intestinal transit worse over time and according to burden.

Inibição do transito gastrintestinal por antipsicoticos: estudo experimental da clozapina

A eficácia da clozapina(CLZ)como um agente antipsicótico atípico foi reconhecida desde o início dos anos 1960, sendo ainda nos dias atuais a droga de escolha no tratamento de casos de esquizofrenia refratários a outros antipsicóticos. Dentre os efeitos adversos da CLZ, a constipaçãoé relatada com frequência, podendo progredir para obstruçãointestinal, necrose intestinal,sepse intrabdominale morte. O presente estudoavaliou o mecanismo de ação da CLZsobre a motilidade gastrintestinalatravés da análise da taxa de trânsito intestinal (TI) e da excreção de pelotas fecais em camundongos. Foram utilizados camundongos Swiss, machos, peso 25-30g, provenientes do Biotério Central da UFC e o projeto foi aprovado pela CEPA/UFC (Proc. No. 57/2014).As drogas utilizadas foram: CLZ (2,5; 5; 10; 20mg/kg), neostigmina (NEO, 1mg/kg i.p.), serotonina (5-HT, 10mg/kg v.o.), alilisitiocianato (AITC 10mg/kg v.o.), domperidona (DOM, 20mg/kg v.o.), L-NAME (80 mg/kg i.p.), naloxona (2mg/kg s.c.), glibenclamida (5mg/kg i.p.) e AM251 (1mg/kg i.p.).A administração oral de CLZ 10 e 20 mg/kgreduziusignificativamente(p<0,05) o transito gastrintestinal (TI) em relação ao veículoa partir desse resultado optou-se pela menor dose efetiva de CLZ sobre a função motora intestinal para as avaliações subsequentes...

Clozapine (CLZ)an atypicalantipsychotic agentrecognized for its efficacy since the early 1960s stillsnowadays the drug of choice in treating refractory schizophrenia cases to other antipsychotics. Among the adverse effects of CLZ, constipation, often reported, may progress to bowel obstruction, intestinal necrosis, intraabdominal sepsis and death. This study evaluated the mechanism of action of CLZ on gastrointestinal motility by analyzingthe intestinal transit rate (IT) and excretionof fecal pellets in mice. Animals usedwereSwiss males, weight 25-30g, from the UFC Central Animal Facility and the project approved by the CEPA / UFC (Proc. No. 57/2014). The drugs used were: CLZ (2.5, 5, 10, 20mg/kgp.o.), neostigmine (NEO 1mg /kg i.p.), serotonin (5-HT, 10mg/kg p.o.), alilisotiocianate(AITC 10mg/kg p.o.) , domperidone (DOM 20mg/kg p.o.), L-NAME (80 mg/kg i.p.), naloxone (2 mg/kg s.c.), glibenclamide (5 mg/kg i.p.) and AM251 (1 mg/kg i.p.). Oral administration of CLZ 10 and 20 mg/kg significantly (p <0.05) inhibited ITfrom the vehicle.Based on the results we decided forthe smallest effective dose of CLZ active on intestinal motor function(10mg/kg)for subsequent evaluations...