Vapreotide, a long-acting somatostatin analogue, dose-dependently inhibits exocrine pancreatic secretion in healthy volunteers

AUCover basal, mean ± SEM, ' p,;O.05VS. placebo (ANOVA followed byMann·Whitney test) mean age 6 (range 1.5 13 years). All underwent endoscopy for clinically indicated problems unrelated to the pyloric area. We placed under endoscopy a 6 fr. impedance catheter with 12 impedance sensors Icm apart (5 antral sensors, 2 pyloric sensors, and 5 duodenal sensors). We recorded BTE for 25 minutes following recovery from endoscopy in each patient. When fully awake, subjects drank water or apple juice. We found pyloric BTEs during II % of fasting recording time and 55% of recording time in the 10 minute following the drink. We analyzed 5 types of BTEs: propagating, retrograde, simultaneous, isolated, and complex. Propagating BTEs consisted of gas andlor fluid movement from antrum through pylorus, pylorus through duodenum, or a combination of the two. Propagating BTEs accounted for 48% of pyloric BTEs. Propagating BTEs averaged20 sec in duration. Retrograde BTEs consisting of fluid moving from duodenum to pylorus, pylorus to antrum, or a combination, accounted for 22% of pyloric BTEs. Retrograde BTEs averaged 10 sec in duration. Simultaneous BTEs consisted of distension in all areas at the same time, accounted for 19% of pyloric BTEs, and averaged 5 sec in duration. Isolated BTEs consisted of movement in the pylorus only and accounted for 5% of BTEs. Isolated BTEs were rhythmic, with clusters of l2/min, 3/min or 12 and 3/min waveforms superimposed. Complex BTEs were multidirectional, and accounted for 6% of all BTEs. We conclude that the patternsof pyloric BTEs are variable. Multichannel intraluminal impedance helps to assess pyloric physiology by determining pyloric bolus direction, duration and composition (gas or fluid). Impedanceshows promise as a method to assess pyloric function in health and in disease.