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Alcohol and gastric motility: pathophysiological and therapeutic implications
  1. Zorisadday Gonzalez1,
  2. Daniel Herlihy1,
  3. Cong Phan2,
  4. Jesus Diaz3,
  5. Kenneth Dominguez3,
  6. Richard McCallum1
  1. 1Gastroenterology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
  2. 2Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA
  3. 3Nuclear Medicine, University Medical Center of El Paso, El Paso, Texas, USA
  1. Correspondence to Dr Zorisadday Gonzalez, Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905-2709, USA; zgonzalez{at}phs.org

Abstract

Alcohol has been associated with alterations in gastric motility. The literature identifies that various factors play a role in alcohol’s effect on gastric emptying including differences in alcohol concentration, osmolarity, caloric content, amino acids as well as different processing techniques (fermentation vs distillation). Additionally, chronic alcohol consumption has been shown to alter the myenteric nitrergic system resulting in impaired gastrointestinal motor function, and it also has an inhibitory effect on the release of several neurotransmitters that play a key role in gastrointestinal motility, including acetylcholine. Whether social or limited intake of alcohol could have a therapeutic role has not been apparent. Serendipitously, we have identified a therapeutic role for alcohol with a meal in the entity of dumping syndrome (DS) where there is postprandial rapid emptying of voluminous and hyperosmolar gastric contents into the small bowel. In the clinical setting of DS attributed to impaired vagal nerve function, there was normalization of gastric emptying and resolution of accompanying symptoms when drinking a glass of wine before and during meals. We propose that alcohol’s anticholinergic effect was augmented in the setting of vagal nerve denervation resulting in slowing of gastric emptying and in alleviation of symptoms of early DS. This review article provides an in-depth analysis of the published literature on alcohol and gastric motility focusing on the accumulated knowledge that may have clinical application and relevance.

  • alcohol drinking
  • gastrointestinal contents
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Footnotes

  • Contributors ZG, DH and CP drafted and edited the article under the guidance of RM. JD helped performed the nuclear medicine studies and participated in acquisition of the data. KD helped performed the nuclear medicine studies and participated in acquisition and interpretation of the data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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