Interdigestive cycling in chronic pancreatitis: altered coordination among pancreatic secretion, motility, and hormones

Gastroenterology. 1995 Jul;109(1):224-30. doi: 10.1016/0016-5085(95)90288-0.


Background & aims: Secretions from the exocrine and endocrine pancreas may modulate interdigestive motility. To test this hypothesis in humans, we investigated interdigestive cycling in patients with chronic pancreatitis (CP) as a model of impaired pancreatic function.

Methods: Antroduodenal motility, pancreatic enzyme output, and pancreatic polypeptide release were monitored for two consecutive interdigestive cycles in 13 controls and 9 patients with CP.

Results: Interdigestive enzyme output was severely impaired in patients with CP (> 80% decrease); however, secretory cycling was still evident in most patients. All parameters describing interdigestive motility were similar in controls and patients with CP (duration of the migrating motor complex [MMC] was 107 +/- 19 minutes in patients with CP vs. 114 +/- 15 minutes in controls). The time between cyclic peaks of enzyme secretion (76 +/- 4 minutes vs. 101 +/- 4 minutes in controls) and pancreatic polypeptide (63 +/- 4 minutes vs. 106 +/- 7 minutes in controls) was shortened in patients with CP, and peaks were no longer temporally related to the MMC. Only 56% of phase III activity fronts were associated with a concomitant secretory peak in patients with CP compared with 92% in healthy subjects.

Conclusions: CP not only decreases pancreatic secretion but interrupts the coordination among interdigestive cyclic phenomena. Our findings in several animal and human models refute the concept that pancreatic mechanisms exert a major regulatory influence on interdigestive motor activity.

MeSH terms

  • Adult
  • Amylases / metabolism
  • Analysis of Variance
  • Chronic Disease
  • Chymotrypsin / metabolism
  • Digestion*
  • Duodenum / physiopathology
  • Female
  • Gastrointestinal Motility*
  • Humans
  • Male
  • Middle Aged
  • Myoelectric Complex, Migrating
  • Pancreas / enzymology
  • Pancreas / metabolism*
  • Pancreatic Polypeptide / metabolism*
  • Pancreatitis / metabolism
  • Pancreatitis / physiopathology*
  • Periodicity*
  • Pyloric Antrum / physiopathology
  • Trypsin / metabolism


  • Pancreatic Polypeptide
  • Amylases
  • Chymotrypsin
  • Trypsin