Morphine and Gastroduodenal Motility

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 1999 Nov 26

PMID 10573360

Citations 7

Authors

T D Lewis

Affiliations

Soon will be listed here.

Abstract

This study investigated the effects of intravenous morphine on gastric antral and duodenal motility in healthy volunteers. Intravenous morphine (both infusion and bolus) increased duodenal motility, typically as bursts of contractions similar to phase III of the migrating motor complex. Intravenous infusion of morphine 40 microg/kg/hr rapidly increased duodenal motility in nine of 10 subjects; in eight it was phase III-like. Intravenous infusion of naloxone (40 microg/kg/hr) blocked this effect of morphine infusion in five of six subjects. Morphine bolus injection (5-20 microg/kg) in six subjects (30-42 min following a spontaneous phase III) induced further duodenal phase III-like activity; also, morphine bolus injection (5-20 microg/kg) in five subjects (30-42 min following a liquid meal) induced duodenal phase III-like activity. Atropine (10 microg/kg intravenously) was able to prevent the action of morphine (both intravenous infusion and intravenous bolus injection) in inducing this phase III-like activity. These observations show: (1) morphine in very low dose is able to stimulate maximal duodenal contractility; (2) the motility response is typically phase III-like; and (3) morphine acts on opioid receptors to initiate this phase III-like activity, with the effect blocked by antimuscarinic drugs.

Citing Articles

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Fluoroscopic Characterization of Colonic Dysmotility Associated to Opioid and Cannabinoid Agonists in Conscious Rats.

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Detection of drug effects on gastric emptying and contractility using a wireless motility capsule.

Rozov-Ung I, Mreyoud A, Moore J, Wilding G, Khawam E, Lackner J BMC Gastroenterol. 2014; 14:2.

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The migrating motor complex: control mechanisms and its role in health and disease.

Deloose E, Janssen P, Depoortere I, Tack J Nat Rev Gastroenterol Hepatol. 2012; 9(5):271-85.

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Epidural administration of morphine facilitates time of appearance of first gastric interdigestive migrating complex in dogs with paralytic ileus after open abdominal surgery.

Nakayoshi T, Kawasaki N, Suzuki Y, Yasui Y, Nakada K, Ishibashi Y J Gastrointest Surg. 2007; 11(5):648-54.

PMID: 17468925 DOI: 10.1007/s11605-006-0065-z.

References

Ingram D, CATCHPOLE B . Effect of opiates on gastroduodenal motility following surgical operation. Dig Dis Sci. 1981; 26(11):989-92. DOI: 10.1007/BF01314760. View

Waterfall W . Electrical patterns in the human jejunum with and without vagotomy: migrating myoelectrical complexes and the influence of morphine. Surgery. 1983; 94(2):186-90. View

Fox J, Track N, Daniel E . Relationship of plasma motilin concentration to fat ingestion, duodenal acidification and alkalinization, and migrating motor complexes in dogs. Can J Physiol Pharmacol. 1981; 59(2):180-7. DOI: 10.1139/y81-030. View

Telford G, Hoshmonai M, Moses A, Szurszewski J . Morphine initiates migrating myoelectric complexes by acting on peripheral opioid receptors. Am J Physiol. 1985; 249(5 Pt 1):G557-62. DOI: 10.1152/ajpgi.1985.249.5.G557. View

Duthie D, Nimmo W . Adverse effects of opioid analgesic drugs. Br J Anaesth. 1987; 59(1):61-77. DOI: 10.1093/bja/59.1.61. View

Thomas P, Kelly K, Go V . Does motilin regulate canine interdigestive gastric motility?. Dig Dis Sci. 1979; 24(8):577-82. DOI: 10.1007/BF01333700. View

Bueno L, Fioramonti J, Rayner V, Ruckebusch Y . Effects of motilin, somatostatin, and pancreatic polypeptide on the migrating myoelectric complex in pig and dog. Gastroenterology. 1982; 82(6):1395-1402. View

Poitras P, Boivin M, Lahaie R, Trudel L . Regulation of plasma motilin by opioids in the dog. Am J Physiol. 1989; 257(1 Pt 1):G41-5. DOI: 10.1152/ajpgi.1989.257.1.G41. View

Sarna S, Northcott P, Belbeck L . Mechanism of cycling of migrating myoelectric complexes: effect of morphine. Am J Physiol. 1982; 242(6):G588-95. DOI: 10.1152/ajpgi.1982.242.6.G588. View

10.

Rees W, Malagelada J, Miller L, Go V . Human interdigestive and postprandial gastrointestinal motor and gastrointestinal hormone patterns. Dig Dis Sci. 1982; 27(4):321-9. DOI: 10.1007/BF01296751. View

11.

Funakoshi A, Vinik A, Owyang C . Plasma motilin concentration and interdigestive migrating motor complex in diabetic gastroparesis: effect of metoclopramide. Gastroenterology. 1985; 88(2):492-9. DOI: 10.1016/0016-5085(85)90512-8. View

12.

Sarna S . Cyclic motor activity; migrating motor complex: 1985. Gastroenterology. 1985; 89(4):894-913. DOI: 10.1016/0016-5085(85)90589-x. View

13.

Kerlin P, Phillips S . Variability of motility of the ileum and jejunum in healthy humans. Gastroenterology. 1982; 82(4):694-700. View

14.

Fox J, Daniel E . Activation of endogenous excitatory opiate pathways in canine small intestine by field stimulation and motilin. Am J Physiol. 1987; 253(2 Pt 1):G189-94. DOI: 10.1152/ajpgi.1987.253.2.G189. View

15.

VANTRAPPEN G, Janssens J, Hellemans J, Ghoos Y . The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. J Clin Invest. 1977; 59(6):1158-66. PMC: 372329. DOI: 10.1172/JCI108740. View

16.

Lewis T, Collins S, Fox J, Daniel E . Initiation of duodenal acid-induced motor complexes. Gastroenterology. 1979; 77(6):1217-24. View

17.

Sarna S . Giant migrating contractions and their myoelectric correlates in the small intestine. Am J Physiol. 1987; 253(5 Pt 1):G697-705. DOI: 10.1152/ajpgi.1987.253.5.G697. View

18.

Telford G, Condon R, Szurszewski J . Opioid receptors and the initiation of migrating myoelectric complexes in dogs. Am J Physiol. 1989; 256(1 Pt 1):G72-7. DOI: 10.1152/ajpgi.1989.256.1.G72. View

19.

Polak J, Bloom S, Sullivan S, Facer P, Pearse A . Enkephalin-like immunoreactivity in the human gastrointestinal tract. Lancet. 1977; 1(8019):972-4. DOI: 10.1016/s0140-6736(77)92277-2. View

20.

Otterson M, Sarna S . Gastrointestinal motor effects of erythromycin. Am J Physiol. 1990; 259(3 Pt 1):G355-63. DOI: 10.1152/ajpgi.1990.259.3.G355. View