Effect of traumatic spinal cord transection on human upper gastrointestinal motility and gastric emptying

Whether transection of the spinal cord, above the level of the sympathetic outflow to the gastrointestinal tract, alters human upper gastrointestinal function is yet unknown. In 5 patients with complete high-cord transection (neurologic level above T1), 3 patients with complete low-cord transections (neurologic level T10 or below), and 4 age- and sex-matched healthy controls, the duration of the phases and cycle length of the interdigestive motor complex were similar. However, the percentage of phase III's of the interdigestive motor complex that originated in the antrum and propagated to the duodenum was significantly decreased in patients with high-cord transections compared with healthy subjects (38% vs. 90%; p less than 0.05), but was similar in patients with low-cord transections and normal controls (75% vs. 90%). After liquid meals, 3 of the 3 high-cord patients tested had reduced cumulative gastric emptying at 60 min postprandially compared with healthy subjects. Thus, interruption of the cervical cord above the level of the sympathetic outflow to the gastrointestinal tract disturbs normal interdigestive antral-duodenal motor coordination and may delay postprandial gastric emptying of liquid meals.