Background
The COVID‐19 pandemic, declared by WHO on March 13, 2020, had a major global impact on the healthcare system and services. In the acute phase, the presence of the SARS‐CoV‐2 virus in the ...aerodigestive tract limited activities in the gastroenterology clinic and procedures to emergencies only. Motility and function testing was interrupted and as we enter the recovery phase, restarting these procedures requires a safety‐focused approach with adequate infection prevention for patients and healthcare professionals.
Methods
We summarized knowledge on the presence of the SARS‐CoV‐2 virus in the aerodigestive tract and the risk of spread with motility and functional testing. We surveyed 39 European centers documenting how the pandemic affected activities and which measures they are considering for restarting these measurements. We propose recommendations based on current knowledge as applied in our center.
Results
Positioning of catheters for gastrointestinal motility tests carries a concern for aerosol‐borne infection of healthcare workers. The risk is low with breath tests. The surveyed centers stopped almost all motility and function tests from the second half of March. The speed of restarting and the safety measures taken varied highly.
Conclusions and Inferences
Based on these findings, we provided recommendations and practical relevant information for motility and function test procedures in the COVID‐19 pandemic era, to guarantee a high‐quality patient care with adequate infection prevention.
Overview of use of Personal Protective Equipment for motility studies during the COVID‐19 pandemic. Left: Donning procedure. Right: Doffing procedure.
Sugar consumption is associated with a whole range of negative health effects and should be reduced and the natural sweetener xylitol might be helpful in achieving this goal. The present study was ...conducted as a randomized, placebo-controlled, double-blind, cross-over trial. Twelve healthy, lean volunteers received intragastric solutions with 7, 17 or 35 g xylitol or tap water on four separate days. We examined effects on: gut hormones, glucose, insulin, glucagon, uric acid, lipid profile, as well as gastric emptying rates, appetite-related sensations and gastrointestinal symptoms. We found: (i) a dose-dependent stimulation of cholecystokinin (CCK), active glucagon-like peptide-1 (aGLP-1), peptide tyrosine tyrosine (PYY)-release, and decelerated gastric emptying rates, (ii) a dose-dependent increase in blood glucose and insulin, (iii) no effect on motilin, glucagon, or glucose-dependent insulinotropic peptide (GIP)-release, (iv) no effect on blood lipids, but a rise in uric acid, and (v) increased bowel sounds as only side effects. In conclusion, low doses of xylitol stimulate the secretion of gut hormones and induce a deceleration in gastric emptying rates. There is no effect on blood lipids and only little effect on plasma glucose and insulin. This combination of properties (low-glycemic sweetener which stimulates satiation hormone release) makes xylitol an attractive candidate for sugar replacement.
Aim
To determine whether a dose‐dependent effect in the stimulation of gut hormone release (plasma cholecystokinin CCK, active glucagon‐like peptide‐1 aGLP‐1 and peptide tyrosine tyrosine PYY) is ...found for the natural sweetener erythritol.
Materials and Methods
Twelve healthy, lean volunteers received solutions with 10, 25 or 50 g erythritol, or tap water enriched with 13C‐sodium acetate on four study days via a nasogastric tube in this randomized (active treatments), placebo‐controlled, double‐blind, cross‐over trial. Blood samples and breath samples (13C‐sodium acetate method for measurement of gastric emptying GE) were taken at regular intervals, and sensations of appetite and gastrointestinal symptoms were rated.
Results
We found (a) a dose‐dependent stimulation of CCK, aGLP‐1 and PYY, and slowing of GE, (b) no effect on blood glucose, insulin, motilin, glucagon or glucose‐dependent insulinotropic polypeptide, (c) no effect on blood lipids and uric acid, and (d) no abdominal pain, nausea or vomiting.
Conclusions
Solutions with 10 and 50 g of erythritol stimulated gut hormone release. Emptying of erythritol‐containing solutions from the stomach was slower compared with placebo. There was no effect on plasma glucose, insulin, glucagon, blood lipids or uric acid. All doses were well tolerated.
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