Gastric emptying of liquids and postprandial pancreatobiliary secretion are temporarily impaired during endotoxemia.

The aims of our study were to determine mechanisms by which pancreatobiliary secretion is altered during endotoxemia. Dogs underwent placement of duodenal perfusion and aspiration catheters and antral manometry catheters. Gastric emptying of liquids, antral motility, output of bile acids and amylase, and serum levels of enteric hormones were determined after ingestion of a 360-kcal mixed-nutrient liquid meal. Each dog was then given a single dose of E. coli lipopolysaccharide (200 microg/kg, intravenously) and the studies repeated for the next three days. Endotoxin slowed gastric emptying of liquids and decreased amylase output for two days. Bile acid output was decreased on postendotoxin day 1. Pancreatic polypeptide alone was decreased on postendotoxin day 1. We conclude that the decrease in pancreatobiliary output is probably due to decreased nutrient flow into the duodenum and not due to decreased production of hormones that influence pancreatobiliary secretion. The delayed gastric emptying, decreased pancreatobiliary output, and decreased postprandial levels of pancreatic polypeptide suggest diminished vagal output as a possible explanation for the effects of endotoxin on upper gut function.