Mechanism of Gastric Emptying of a Nondisintegrating Radiotelemetry Capsule in Man

Abstract

We studied the mechanism of gastric emptying of a pH-sensitive radiotelemetry capsule with respect to phases of the interdigestive migrating motor complex (IMMC) in fasting normal volunteers and the effect of the Heidelberg capsule (HC) on the duration or timing of the IMMC phases. A manometric catheter with eight mounted solid-state strain gauges was passed transnasally and positioned fluoroscopically in the duodenum and jejunum in four normal, fasted male volunteers, in their right lateral position. The HC was administered orally following the establishment of one complete IMMC cycle (defined by the recording time between the end of two subsequent phase III activity fronts) and during the beginning of Phase I of the next cycle. The gastric residence time (GRT) of the HC was measured as the time of a gastric pH rise of ≥3.0 units. In three subjects, GRT of the HC lasted to within 5 min of the onset of the next duodenal phase III of the IMMC, while in the fourth subject, the HC passed during the second phase III activity front. There were no significant differences in the duration of each phase of duodenal IMMC in the presence or absence of the HC (Phase I, 54 ± 9.3 vs 31.6 ± 10.1; Phase II, 22 ± 8.1 vs 58.9 ± 32; Phase III, 5.3 ± 0.7 vs 4.2 ± 0.7 min; mean ± SE; P > 0.1 in all phases). In addition, the HC had no effect on motility index or patterns of contractions. The Heidelberg radiotelemetry device (7 × 20 mm) may be used as a noninvasive, nonradioactive means of measuring the activity of the IMMC and the presence of Phase III peak IMMC activity. Further, it permits detailed evaluation of the emptying patterns of solid dosage forms (i.e., enteric-coated tablet or controlled-release matrix) in humans under fasted or fed conditions.