A ROENTGENOLOGICAL STUDY OF GASTRIC HUNGER MOTILITY IN A SERIES OF HEALTHY MEN

Abstract

Radiographic and fluoroscopic examinations of gastric hunger contractions have been made on 5 healthy men with simultaneous graphic registration by the rubber balloon and manometer method. This gastric hunger motility is a mixture of at least 2 types of activity: (1) hyper-peristalsis and (2) tonic or circular contraction of the lower third or antral end of the stomach. Visible tonic or maintained contractions of the fundus were not constant characteristics of hunger contractions; sometimes this portion of the stomach is dilated or distended by the greater degree of contractility of the lower portion of the stomach; at other times an apparent shortening or contraction of the entire fundus appeared. The 20 seconds'' pressure rhythm of the graphic tracing is associated with simple peristalsis. In type I contractions there occurs first a shallow peristaltic wave followed by a strong antral contraction which is immediately followed by a deep peristaltic wave. The type II contraction is similar to that of type I. There occurs first a contraction of the antrum but the following peristaltic wave may originate high in the fundus, even at or near the cardiac sphincter, and sweep over the entire stomach, terminating in an antral contraction completely obliterating the lumen of the lower half or third of the stomach. Periods of gastric tetany, as studied by the graphic method, are characterized by repeated contractions with maintained "tonus" or increased intragastric pressure. This maintained intra-gastric pressure (it can be seen fluoroscopically or from radiographs) is due to either or both of 2 factors: (1) increased constriction of the antral end of the stomach; (2) hyper-peristalsis at such a rate that a 2nd deep wave appears before the preceding one has disappeared. The most striking feature was the observation of the complete obliteration of the lumen of the lower portion of the stomach at the height of the hunger contraction. It is at this time that the subject feels the contraction most intensely.