Role of intestinal chemoreception in the induction of gastrointestinal sensations

Both distension of the stomach and activation of small intestinal chemoreceptors by nutrients have been implicated in the induction of postprandial sensations. Studies were performed in healthy human subjects to investigate the roles of gastric distension and activation or inhibition of small intestinal chemoreceptors in the generation of pleasant (fullness) and unpleasant (nausea, pain) gastrointestinal sensations. The proximal stomach was distended by inflating a balloon attached to a gastric tube with air, while the duodenum was perfused with nutrient solutions, either lipid or carbohydrates. In additional experiments, the upper small intestinal mucosa was anaesthetised by topical anaesthesia or an antagonist to cholecystokinin (CCK)-A receptors given intravenously during duodenal lipid infusion. Gastric distension induced sensations of epigastric pressure and pain, while during duodenal infusion of both carbohydrate and lipid, fullness was described as a more meal-like sensation. In addition, lipid but not carbohydrate infusion resulted in significant nausea. The sensory experience evoked by lipid was diminished by both topical mucosal anaesthesia and CCK-A receptor blockade. The data provide evidence for the involvement of small intestinal chemoreceptors in the modulation of sensations induced by gastric distension.