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Influence of erythromycin on gastric emptying and meal related symptoms in functional dyspepsia with delayed gastric emptying.
Gut. 2005 Apr; 54(4):455-60.Gut

Abstract

BACKGROUND AND AIMS

Although delayed gastric emptying is considered a major pathophysiological mechanism in functional dyspepsia, the efficacy of prokinetic drugs has not been established. Recent studies using macrolide prokinetics were negative but receptor desensitisation may have played a role. The aim of the present study was to evaluate the influence on meal induced symptoms of acutely administered erythromycin in patients with gastroparesis.

METHODS

In 20 patients with functional dyspepsia, gastric emptying was studied twice using the (14)C octanoic acid and (13)C glycin breath test to establish the reproducibility of the test. Breath samples were taken before the meal and at 15 minute intervals for a period of 240 minutes postprandially. At each breath sampling, the patient was asked to grade the intensity (0-3) of six dyspeptic symptoms. Twenty four patients (three men, mean age 43.5 (3) years) with dyspeptic symptoms and delayed gastric emptying were studied twice after pretreatment with saline or erythromycin intravenously.

RESULTS

Meal related symptom severity scores were reproducible. Treatment with erythromycin significantly enhanced solid and liquid gastric emptying (t(1/2) 146 (27) v 72 (7) minutes, respectively (p<0.01), and 87 (6) v 63 (5) minutes (p<0.001)). Only the severity of bloating was significantly improved by erythromycin (23 (3.9) v 14.5 (2.7); p<0.01); all other symptoms and the cumulative meal related symptom score were not altered by erythromycin.

CONCLUSIONS

In a setting where desensitisation played no role, erythromycin enhanced gastric emptying was not associated with a beneficial effect on meal related symptom severity.

Authors+Show Affiliations

Department of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15753526

Citation

Arts, J, et al. "Influence of Erythromycin On Gastric Emptying and Meal Related Symptoms in Functional Dyspepsia With Delayed Gastric Emptying." Gut, vol. 54, no. 4, 2005, pp. 455-60.
Arts J, Caenepeel P, Verbeke K, et al. Influence of erythromycin on gastric emptying and meal related symptoms in functional dyspepsia with delayed gastric emptying. Gut. 2005;54(4):455-60.
Arts, J., Caenepeel, P., Verbeke, K., & Tack, J. (2005). Influence of erythromycin on gastric emptying and meal related symptoms in functional dyspepsia with delayed gastric emptying. Gut, 54(4), 455-60.
Arts J, et al. Influence of Erythromycin On Gastric Emptying and Meal Related Symptoms in Functional Dyspepsia With Delayed Gastric Emptying. Gut. 2005;54(4):455-60. PubMed PMID: 15753526.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of erythromycin on gastric emptying and meal related symptoms in functional dyspepsia with delayed gastric emptying. AU - Arts,J, AU - Caenepeel,P, AU - Verbeke,K, AU - Tack,J, PY - 2005/3/9/pubmed PY - 2005/4/12/medline PY - 2005/3/9/entrez SP - 455 EP - 60 JF - Gut JO - Gut VL - 54 IS - 4 N2 - BACKGROUND AND AIMS: Although delayed gastric emptying is considered a major pathophysiological mechanism in functional dyspepsia, the efficacy of prokinetic drugs has not been established. Recent studies using macrolide prokinetics were negative but receptor desensitisation may have played a role. The aim of the present study was to evaluate the influence on meal induced symptoms of acutely administered erythromycin in patients with gastroparesis. METHODS: In 20 patients with functional dyspepsia, gastric emptying was studied twice using the (14)C octanoic acid and (13)C glycin breath test to establish the reproducibility of the test. Breath samples were taken before the meal and at 15 minute intervals for a period of 240 minutes postprandially. At each breath sampling, the patient was asked to grade the intensity (0-3) of six dyspeptic symptoms. Twenty four patients (three men, mean age 43.5 (3) years) with dyspeptic symptoms and delayed gastric emptying were studied twice after pretreatment with saline or erythromycin intravenously. RESULTS: Meal related symptom severity scores were reproducible. Treatment with erythromycin significantly enhanced solid and liquid gastric emptying (t(1/2) 146 (27) v 72 (7) minutes, respectively (p<0.01), and 87 (6) v 63 (5) minutes (p<0.001)). Only the severity of bloating was significantly improved by erythromycin (23 (3.9) v 14.5 (2.7); p<0.01); all other symptoms and the cumulative meal related symptom score were not altered by erythromycin. CONCLUSIONS: In a setting where desensitisation played no role, erythromycin enhanced gastric emptying was not associated with a beneficial effect on meal related symptom severity. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/15753526/Influence_of_erythromycin_on_gastric_emptying_and_meal_related_symptoms_in_functional_dyspepsia_with_delayed_gastric_emptying_ DB - PRIME DP - Unbound Medicine ER -