Effect of prolonged hyperdynamic endotoxemia on jejunal motility in fasted and enterally fed pigs

Objective To determine the effects of hyperdynamic endotoxemia on the motility of the small intestine. Summary Background Data Motility disorders of the gastrointestinal tract are a common complication of sepsis. It has been suggested that gram-negative endotoxin plays a role in the pathogenesis of the accompanying diarrhea frequently observed. Methods Pigs were infused with Escherichia coli lipopolysaccharide for a 24-hour period. During this fasting period jejunal motility was measured using ambulatory manometry. One and 4 days after cessation of endotoxin, pigs were enterally fed, and again motility was recorded. Results Hyperdynamic endotoxemia was achieved in this model. Manometric pressure recordings revealed that endotoxin infusion accelerated the migrating motor complex (MMC) migration along the jejunum. Also, a simultaneous increase in MMC cycling frequency was observed in the endotoxin-treated group. Elevated MMC migration velocity and cycling frequency were maintained the following day after endotoxin during feeding and returned to basal values 4 days after endotoxin. Conclusions A small dose of continuously infused endotoxin significantly provokes jejunal motility disturbances that may contribute to diarrhea.