The nocturnal jejunal migrating motor complex: defining normal ranges by study of 51 healthy adult volunteers and meta-analysis

Interdigestive human small bowel motility is characterized by the migrating motor complex (MMC). The aims of this study were to: (i) establish the normal range of variables of the nocturnal jejunal MMC and (ii) incorporate these data in a subsequent meta-analysis. Eighty-one recordings were performed by prolonged (24 h) ambulatory manometry in 51 subjects in two centres. Quantitative analysis was undertaken of 419 Phase III and 332 Phase II episodes. Adjusted mean values of seven variables were calculated using a mixed-effects model. Meta-analysis of pooled published data to generate a reliable 95% reference range was also performed. Adjusted mean values and confidence intervals are presented for all seven variables. Intrasubject variances were large in comparison with intersubject. Meta-analysis of 19 studies (356 pooled patients) meeting inclusion criteria produced wide reference ranges. At least five such ranges are useful for the detection of abnormality in the individual. This is the largest study of normal volunteers presented to date, with ranges for many variables produced using appropriate statistical methodology. A model for definition of abnormality has been proposed. We recommend that these data may be used by investigators in this field as a complement to other existing indicators of small bowel dysmotility.     

A 20-year perspective – from Journal of Gastrointestinal Motility to Neurogastroenterology and Motility

Abstract  This review traces the origins of this journal as the consequence of a revolution in academic publishing that started in Oxford 50 years ago. It also traces the expansion of the field of gastrointestinal motility by the development of new methodology that prompted both the creation of learned societies and a role for a journal devoted to this field. The problems that arose because the new journal was an 'orphan journal' lacking a parent society are recounted, as are the events that eventually led to its adoption. Finally, the introduction of the term 'neurogastroenterology' into scientific and clinical parlance is explained.