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Microgravity Simulated by the 6° Head-Down Tilt Bed Rest Test Increases Intestinal Motility but Fails to Induce Gastrointestinal Symptoms of Space Motion Sickness

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Abstract

Background

Space motion sickness (SMS) is the most relevant medical problem during the first days in microgravity. Studies addressing pathophysiology in space face severe technical challenges and microgravity is frequently simulated using the 6° head-down tilt bed rest test (HDT).

Aim

We were aiming to test whether SMS could be simulated by HDT, identify related changes in gastrointestinal physiology and test for beneficial effects of exercise interventions.

Methods

HDT was performed in ten healthy individuals. Each individual was tested in three study campaigns varying by a 30-min daily exercise intervention of either standing, an upright exercise regimen, or no intervention. Gastrointestinal symptoms, stool characteristics, gastric emptying time, and small intestinal transit were assessed using standardized questionnaires, 13C octanoate breath test, and H2 lactulose breath test, respectively, before and at day 2 and 5 of HDT.

Results

Individuals described no or minimal gastrointestinal symptoms during HDT. Gastric emptying remained unchanged relative to baseline data collection (BDC). At day 2 of HDT the H2 peak of the lactulose test appeared earlier (mean ± standard error for BDC-1, HDT2, HDT5: 198 ± 7, 139 ± 18, 183 ± 10 min; p: 0.040), indicating accelerated small intestinal transit. Furthermore, during HDT, stool was softer and stool mass increased (BDC: 47 ± 6, HDT: 91 ± 12, recovery: 53 ± 8 g/day; p: 0.014), indicating accelerated colonic transit. Exercise interventions had no effect.

Conclusion

HDT did not induce symptoms of SMS. During HDT, gastric emptying remained unchanged, but small and large intestinal transit was accelerated.

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Acknowledgments

All experiments were performed at the German Aerospace Center (Cologne, Germany), and we would like to thank the stuff for their support and the subjects for their commitment. The authors would like to thank Dieter Menne for help with the analysis of gastric emptying. BM and MP received financial support from the Swiss Cancer league and the Horten foundation.

Conflict of interest

The authors declare no conflicts of interest.

Author information

Author notes

    Authors and Affiliations

    1. Division of Gastroenterology and Hepatology, University Hospital Zurich and Zurich University, Rämistr. 100, 8091, Zurich, Switzerland

      Meher Prakash, Ron Fried, Mark Fox, Michael Fried, Werner Schwizer & Benjamin Misselwitz

    2. Division of Hepatology, Department of Medicine II, University Hospital Würzburg, Würzburg, Germany

      Oliver Götze

    3. Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany

      Francisca May, Petra Frings-Meuthen & Edwin Mulder

    4. Swiss Center of Excellence for Agricultural Research (Agroscope), Bern, Switzerland

      Judit Valentini

    5. Zurich Integrative Human Physiology Group, University of Zurich, Zurich, Switzerland

      Mark Fox, Michael Fried & Werner Schwizer

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    Correspondence to Benjamin Misselwitz.

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    Meher Prakash and Ron Fried have contributed equally to this work.

    Glossary

    BDC

    Baseline data correction

    BSS

    Bristol Stool Scale

    CON

    Control group

    DLR

    German Aerospace Center (“Deutsches Institut für Luft- und Raumfahrt”)

    ESA

    European Space Agency

    GCSI

    Gastroparesis cardinal symptom index

    GI

    Gastrointestinal investigation

    HDT

    6° head-down tilt bed rest test

    LDQ

    Leeds dyspepsia questionnaire

    LRT

    Locomotion replacement training

    SIBO

    Small intestinal bacterial overgrowth

    SMS

    Space motion sickness

    STA

    Standing intervention

    VAS

    Visual analog scale

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    Prakash, M., Fried, R., Götze, O. et al. Microgravity Simulated by the 6° Head-Down Tilt Bed Rest Test Increases Intestinal Motility but Fails to Induce Gastrointestinal Symptoms of Space Motion Sickness. Dig Dis Sci 60, 3053–3061 (2015). https://doi.org/10.1007/s10620-015-3738-1

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    • DOI: https://doi.org/10.1007/s10620-015-3738-1

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