Effect of Billroth II operation on the intestinal interdigestive motor activity

The interdigestive motor activity of the gastric remnant and the efferent jejunal loop was studied manometrically in 10 patients who underwent Billroth II operation for duodenal ulcer. Two groups, one of 9 normal subjects and the other of 7 duodenal ulcer patients, were used as controls. In the Billroth II group the interdigestive migrating motor complex (IMMC) showed a higher relative duration of phase II activity than the controls and a shorter mean time-interval than the controls between subsequent activity fronts, with abnormal jejunal propagation. These findings indicate that the distal two-thirds of the stomach are necessary for the inhibitory mechanism, which in normal conditions slow down the idiointestinal interdigestive motor activity to the level of that of the stomach, and suggest that some postgastrectomy syndromes, such as diarrhoea, may have their pathological basis in this hyperactive intestinal IMMC.