Intestinal wall motion, propulsion, and fluid movement: trends toward a unified theory

Characterization of flow and mixing regimes within the ileum of the brushtail possum using residence time distribution analysis with simultaneous spatio-temporal mapping

We studied the flow and mixing regimes in isolated segments of the terminal ileum of brushtail possums during spontaneous circumferential and longitudinal contractions under conditions that allowed backflow and compared them with those of inactive segments. Residence time distributions (RTDs) were determined by perfusion with two probes of different rheological properties to which an inert dye marker was added. Ileal segment volume and oscillatory flow during the period of RTD determination were derived from spatiotemporal maps. High viscosity guar gum solution generated RTDs characteristic of laminar flow in inactive ileal segments which confirmed that no slip was occurring at the mucosal layer. In active segments, motility and consequent oscillatory flow imparted significant additional axial dispersion to the flow patterns of both probes. Mixing occurred episodically during periods when intestinal volume was reduced and onflow was augmented by peristalsis, which may prevent the establishment of steady state conditions. Marker concentration rose more steeply when active ileal segments were being perfused with a probe of similar viscosity to normal digesta than with low viscosity Earle's/Hepes solution, each being subject to similar levels of oscillatory flow. This indicated that a coarser mixing regime prevailed and that absorption of nutrients from viscous digesta would rely to a greater degree on molecular diffusion.

Flow fields generated by peristaltic reflex in isolated guinea pig ileum: impact of contraction depth and shoulders

The guinea pig ileum responds to distension with characteristic wall movements, luminal pressure gradients, and outflow (the peristaltic reflex). To date, little is known about whether the peristaltic reflex generates flow events other than laminar flow. Here we used a numerical method to solve for the flow generated by moving walls to assess occlusive contractions (case 1), nonocclusive contractions (case 2), and contractions with steep shoulders (case 3) for which visual parameters of wall movements are published. We found that all three contraction cases produced pressure differentials across the coapting segment, downstream and reverse flow, and vortical flow patterns that redistributed particles and mixed liquids. Contractions generated pressures and shear stresses, particularly along the moving section of the wall. The nonocclusive contraction was much less effective than the occlusive contraction with the steep shoulders; the occlusive contraction with flat shoulders had an intermediate effect. Our analysis shows that even peristaltic contractions produce not only laminar flow but also many flow events likely to promote digestion and absorption. The visual patterns of contractions impact the patterns of luminal flow, and precise definition of wall movements is critical to quantify the fluid mechanical consequences of intestinal contractions.