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Evaluation of gastric emptying and motility in diabetic gastroparesis with magnetic resonance imaging: effects of cisapride.
Am J Gastroenterol. 1999 Oct; 94(10):2866-73.AJ

Abstract

OBJECTIVE

The motor mechanisms that underlie both slow gastric emptying in diabetic gastroparesis and its acceleration by cisapride are poorly understood. We have recently shown that magnetic resonance imaging (MRI) allows concurrent evaluation of both gastric emptying and regional gastric motility.

METHODS

Emptying and motility were measured in eight diabetic patients with previously demonstrated delayed gastric emptying using a rapid MRI technique during oral administration of cisapride and placebo. Studies were performed in a double blind fashion and each patient acted as his own control. Subjects were studied supine for 120 min in a 1.5 Tesla MRI scanner after ingestion of 500 ml of 10% Intralipid. Gastric emptying corrected for the volume of secretions was determined every 15 min using transaxial scans. Each transaxial scan was followed by 120 coronal scans at 1 s intervals. Coronal scans were angled to provide simultaneous imaging of the proximal and distal stomach. MRI studies were also performed in seven diabetic patients with normal emptying who served as disease controls.

RESULTS

Emptying was slower in the gastroparetic patients (t(1/2): 124 +/- 10 min) compared to patients with normal emptying (81 +/- 9 min, p < 0.05). Cisapride accelerated gastric emptying (74 +/- 5 vs 124 +/- 10 min) in patients with gastroparesis. The contraction amplitudes in the proximal stomach of gastroparetic patients were increased during cisapride treatment (17.2% +/- 1.8% vs 13.2% +/- 0.6%; p < 0.02), whereas antral contraction frequency, amplitude, and velocity were unchanged.

CONCLUSIONS

We conclude that cisapride-induced acceleration of liquid gastric emptying in diabetic gastroparesis does not appear to result from changes in antral contractility, but may be related to changes in proximal gastric tone or gastric outlet resistance.

Authors+Show Affiliations

Department of Gastroenterology, University Hospital Zurich, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10520835

Citation

Borovicka, J, et al. "Evaluation of Gastric Emptying and Motility in Diabetic Gastroparesis With Magnetic Resonance Imaging: Effects of Cisapride." The American Journal of Gastroenterology, vol. 94, no. 10, 1999, pp. 2866-73.
Borovicka J, Lehmann R, Kunz P, et al. Evaluation of gastric emptying and motility in diabetic gastroparesis with magnetic resonance imaging: effects of cisapride. Am J Gastroenterol. 1999;94(10):2866-73.
Borovicka, J., Lehmann, R., Kunz, P., Fraser, R., Kreiss, C., Crelier, G., Boesiger, P., Spinas, G. A., Fried, M., & Schwizer, W. (1999). Evaluation of gastric emptying and motility in diabetic gastroparesis with magnetic resonance imaging: effects of cisapride. The American Journal of Gastroenterology, 94(10), 2866-73.
Borovicka J, et al. Evaluation of Gastric Emptying and Motility in Diabetic Gastroparesis With Magnetic Resonance Imaging: Effects of Cisapride. Am J Gastroenterol. 1999;94(10):2866-73. PubMed PMID: 10520835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of gastric emptying and motility in diabetic gastroparesis with magnetic resonance imaging: effects of cisapride. AU - Borovicka,J, AU - Lehmann,R, AU - Kunz,P, AU - Fraser,R, AU - Kreiss,C, AU - Crelier,G, AU - Boesiger,P, AU - Spinas,G A, AU - Fried,M, AU - Schwizer,W, PY - 1999/10/16/pubmed PY - 1999/10/16/medline PY - 1999/10/16/entrez SP - 2866 EP - 73 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 94 IS - 10 N2 - OBJECTIVE: The motor mechanisms that underlie both slow gastric emptying in diabetic gastroparesis and its acceleration by cisapride are poorly understood. We have recently shown that magnetic resonance imaging (MRI) allows concurrent evaluation of both gastric emptying and regional gastric motility. METHODS: Emptying and motility were measured in eight diabetic patients with previously demonstrated delayed gastric emptying using a rapid MRI technique during oral administration of cisapride and placebo. Studies were performed in a double blind fashion and each patient acted as his own control. Subjects were studied supine for 120 min in a 1.5 Tesla MRI scanner after ingestion of 500 ml of 10% Intralipid. Gastric emptying corrected for the volume of secretions was determined every 15 min using transaxial scans. Each transaxial scan was followed by 120 coronal scans at 1 s intervals. Coronal scans were angled to provide simultaneous imaging of the proximal and distal stomach. MRI studies were also performed in seven diabetic patients with normal emptying who served as disease controls. RESULTS: Emptying was slower in the gastroparetic patients (t(1/2): 124 +/- 10 min) compared to patients with normal emptying (81 +/- 9 min, p < 0.05). Cisapride accelerated gastric emptying (74 +/- 5 vs 124 +/- 10 min) in patients with gastroparesis. The contraction amplitudes in the proximal stomach of gastroparetic patients were increased during cisapride treatment (17.2% +/- 1.8% vs 13.2% +/- 0.6%; p < 0.02), whereas antral contraction frequency, amplitude, and velocity were unchanged. CONCLUSIONS: We conclude that cisapride-induced acceleration of liquid gastric emptying in diabetic gastroparesis does not appear to result from changes in antral contractility, but may be related to changes in proximal gastric tone or gastric outlet resistance. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/10520835/Evaluation_of_gastric_emptying_and_motility_in_diabetic_gastroparesis_with_magnetic_resonance_imaging:_effects_of_cisapride_ L2 - https://Insights.ovid.com/pubmed?pmid=10520835 DB - PRIME DP - Unbound Medicine ER -