Clinimeal (Eisai, Tokyo) is a semi-digested, low residue diet for tube feeding. We studied the responses of blood sugar, insulin, pancreatic polypeptide (PP), cholecystokinin (CCK) and gastrin using specific RIA methods and exocrine pancreatic secretion and gall bladder contraction using triple lumen tube to intraduodenal ingestion of Clinimeal 100 Kcal/hr in eight healthy male adults. After intraduodenal infusion of Clinimeal resulted in a significant rise of blood sugar, serum insulin and plasma CCK from the basal values and returned to the basal level after cessation the infusion. Plasma PP also rose significantly after Clinimeal infusion and sustained the elevation after cessation the infusion. Plasma gastrin, however, did not change. Pancreatic secretion of flow, amylase and bicarbonate output, gall bladder contraction paralleled that of the circulating CCK level. Thus, Clinimeal can significantly stimulate the release of CCK from the upper small intestine and PP from the pancreas, raising the physiological concentration of plasma CCK and PP. This level of CCK can evoke a significant increase in exocrine pancreatic secretion and gall bladder contraction. The sustained elevation of PP may work on an anti-CCK factor.
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