Skip to main content

Advertisement

SpringerLink
Log in

Nifedipine and verapamil inhibit the sigmoid colon myoelectric response to eating in healthy volunteers

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

BACKGROUND: Constipation is not an infrequent side effect complained of by patients taking calcium channel blockers. This effect may reduce patients' compliance and yield potentially serious consequences. However, the underlying mechanisms for constipation caused by such compounds are not known. AIMS: The purpose of the present study was to assess the effects of nifedipine and verapamil on the sigmoid myoelectric response to eating, a physiologic test of colonic motor function. SUBJECTS AND METHODS: Nine healthy male volunteers with no previous abdominal surgery were recruited for the study and underwent three paired studies at two-week intervals. Myoelectric sigmoid activity was recorded by means of two clip electrodes introduced within the viscus without preparation for 30 minutes basally and 90 minutes postprandially. Each study was preceded by placebo, nifedipine (20 mg), or verapamil (120 mg). RESULTS: Analysis of the tracings revealed that nifedipine strongly inhibited the sigmoid myoelectric response to the meal. This response was also significantly reduced in those taking verapamil compared with the placebo group, although to a much lesser extent than in those taking nifedipine. CONCLUSIONS: We conclude that constipation as a result of some calcium channel blockers may be caused by inhibition of colonic motor activity by nifedipine and, to a lesser extent, by verapamil. The latter compound probably displays other mechanisms (reduced colonic transit, increased water absorption) also responsible for this side effect.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kiowski W, Bühler FR, Fayadomi M,et al. Age, race, blood pressure and renin: predictors for antihypertensive treatment with calcium antagonists. Am J Cardiol 1986;56:81H-5H.

    Article  Google Scholar 

  2. Council of Scientific Affairs. Calcium cannel blocking agents. JAMA 1983;250:2522–4.

    Google Scholar 

  3. Traube M, McCallum RW. Calcium-channel blockers and the gastrointestinal tract. Am J Gastroenterol 1984;79:892–6.

    PubMed  Google Scholar 

  4. Oates JA. Antihypertensive agents and the drug therapy of hypertension. In: Hardman JG, Goodman Gilman A, Limbird E, eds. Goodman & Gilman's the pharmacological basis of therapeutics. 9th ed. New York: McGraw-Hill, 1996;780–808.

    Google Scholar 

  5. Christensen J. The response of the colon to eating. Am J Clin Nutr 1985;42:1025–32.

    PubMed  Google Scholar 

  6. Schang JC, Devroede G. Fasting and postprandial myoelectric spiking activity in the human sigmoid colon. Gastroenterology 1983;85:1048–53.

    PubMed  Google Scholar 

  7. Wright SH, Snape WJ, Battle W, Cohen S, London RL. Effect of dietary components on gastrocolonic response. Am J Physiol 1980;238:G228–32.

    PubMed  Google Scholar 

  8. Narducci F, Bassotti G, Daniotti S, del Soldato P, Pelli MA, Morelli A. Identification of muscarinic receptor subtype mediating colonic response to eating. Dig Dis Sci 1985;30:124–8.

    Article  PubMed  Google Scholar 

  9. Bassotti G, Morelli A, Whitehead WE. Abnormal rectosigmoid myoelectric response to eating in patients with severe idiopathic constipation (slow-transit type). Dis Colon Rectum 1992;35:753–6.

    Article  PubMed  Google Scholar 

  10. Drug information for the health care professional. USPDI, 15th ed. Rockville: The Unites States Pharmacopeial Convention, Inc., 1995.

  11. Snape WJ, Wright SJ, Battle WM, Cohen S. The gastrocolonic response: evidence for a neural mechanism. Gastroenterology 1979;77:1235–40.

    PubMed  Google Scholar 

  12. Bassotti G, Betti C, Imbimbo BP, Pelli MA, Morelli A. Colonic motor response to eating: a manometric investigation in proximal and distal portions of the viscus in man. Am J Gastroenterol 1989;84:118–22.

    PubMed  Google Scholar 

  13. Bassotti G, Imbimbo BP, Betti C, Dozzini G, Morelli A. Impaired colon motor response to eating in patients with slow transit constipation. Am J Gastroenterol 1992;87:504–8.

    PubMed  Google Scholar 

  14. Logan RL. The efficacy and tolerance to three doses of diltiazem in elderly patients with stable angina. Eur J Clin Pharmacol 1988;33:561–4.

    Article  PubMed  Google Scholar 

  15. Dorhehl IC, Pilloy W, Meywe BJ, Du Plessis M, Maree M. The detection and evaluation of drug-induced changes in the gastrointestinal motility of beagle dogs using a111-In-labelled resin mixed into a standard meal as a tracer. Eur J Nucl Med 1985;10:283–5.

    PubMed  Google Scholar 

  16. Traube M, Lange RC, McAllister RG, McCallum RW. Effect of nifedipine on gastric emptying in normal subjects. Dig Dis Sci 1985;30:710–2.

    Article  PubMed  Google Scholar 

  17. Santander RM, Mena I, Gramisu M, Valenzuela JE. Effect of nifedipine on gastric emptying and gastrointestinal motility in man. Dig Dis Sci 1988;33:535–9.

    Article  PubMed  Google Scholar 

  18. Krevsky B, Maurer AH, Newiarowski T, Cohen S. Effect of verapamil on human intestinal transit. Dig Dis Sci 1992;37:919–24.

    Article  PubMed  Google Scholar 

  19. Chiarioni G, Scattolini C, Bonfante F, Brentegani MT, Vantini I. Effect of nifedipine on mouth-to-cecum transit of liquid meal in normal subjects. Dig Dis Sci 1993;38:1022–5.

    Article  PubMed  Google Scholar 

  20. Droogmans G, Himpens B, Casteels R. Effect of pinaverium bromide on electrical and mechanical activity of smooth muscle cells: Ca++ entry blocking properties. Naunyn Schmiedebergs Arch Pharmacol 1983;323:72–7.

    Article  PubMed  Google Scholar 

  21. Mironneau J, Lalanne C, Mironneau C, Savineau JP, Lovie JL. Comparison of pinaverium bromide, manganese chloride and D600 effects on electrical and mechanical activities in rat uterine smooth muscle. Eur J Clin Pharmacol 1984;98:99–107.

    Article  Google Scholar 

  22. Chaussade S, Roche H, Fallet M, Couturier D, Guerre J. Effects of an intestinal smooth muscle calcium channel blocker (pinaverium bromide) on colonic transit time in humans. J Gastrointest Motil 1990;2:176–9.

    Google Scholar 

  23. Hyman PE, Hsu CT, Jing J, Tomomasa T, Kao HW, Snape WJ. [3H]Nitrendipine binding to rabbit colonic smooth muscle. J Gastrointest Motil 1990;2:53–9.

    Google Scholar 

  24. Barone FC, White RF, Ormsbee HS, Wassermann MA. Effects of calcium channel entry blockers, nifedipine and nilvadipine, on colonic motor activity. J Pharmacol Exp Ther 1986;237:99–106.

    PubMed  Google Scholar 

  25. Lecchini S, Marcoli M, De Ponti F, Castelletti CA, Frigo GM. Selectivity of Ca2+ channel blockers in inhibiting muscular and nerve activities in isolated colon. Br J Pharmacol 1991;102:735–41.

    PubMed  Google Scholar 

  26. Schang JC, Devroede G, Duguay C, Hémond M, Hébert M. Constipation par inertie colique et obstruction distale: étude electomyographique. Gastroenterol Clin Biol 1985;9:480–5.

    PubMed  Google Scholar 

  27. Reynolds JC, Ouyang A, Lee CA, Baker L, Sunshine AG, Cohen S. Chronic severe constipation: prospective motility studies in 25 consecutive patients. Gastroenterology 1987;92:414–20.

    PubMed  Google Scholar 

  28. Sun WM, Edwards CA, Prior A, Rao SS, Read NW. Effect of oral nicardipine on anorectal function in normal human volunteers and patients with irritable bowel syndrome. Dig Dis Sci 1990;35:885–90.

    Article  PubMed  Google Scholar 

  29. Narducci F, Bassotti G, Gaburri M, Farroni F, Morelli A. Nifedipine reduces the colonic motor response to eating in patients with the irritable colon syndrome. Am J Gastroenterol 1985;80:317–9.

    PubMed  Google Scholar 

  30. Narducci F, Bassotti G, Granata MT,et al. Colonic motility and gastric emptying in patients with irritable bowel syndrome: effect of pretreatment with octylonium bromide. Dig Dis Sci 1986;31:241–6.

    Article  PubMed  Google Scholar 

  31. Prior A, Harris SR, Whorwell PJ. Reduction of colonic motility by intravenous nicardipine in irritable bowel syndrome. Gut 1987;28:1609–12.

    PubMed  Google Scholar 

  32. Gwee KA, Read NW. Rolling review: disorders of gastrointestinal motility—therapeutic potentials and limitations. Aliment Pharmacol Ther 1994;8:105–18.

    PubMed  Google Scholar 

  33. Farrugia G, Camilleri M, Whitehead WE. Therapeutic strategies for motility disorders: medications, nutrition, biofeedback, and hypnotherapy. Gastroenterol Clin North Am 1996;25:225–46.

    Article  PubMed  Google Scholar 

  34. Prior A, Whorwell PJ. A double blind study of nicardipine in irritable bowel syndrome. Eur J Gastroenterol Hepatol 1991;3:181–4.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gastrointestinal Motility Laboratory, GI and Endoscopy Unit Section, Department of Clinical Medicine, Pathology, and Pharmacology, University of Perugia Medical School, Perugia, Italy

    Gabrio Bassotti M.D., Ph.D. (F.A.C.G.), Calcedonio Calcara M.D., Serafina Fiorella M.D., Paola Roselli M.D. & Antonio Morelli M.D.

  2. the GI Division, “C.S.S.”-IRCSS, San Giovanni Rotondo Hospital, San Giovanni Rotondo, Italy

    Vito Annese M.D.

Authors
  1. Gabrio Bassotti M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Calcedonio Calcara M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vito Annese M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Serafina Fiorella M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paola Roselli M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Antonio Morelli M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Bassotti, G., Calcara, C., Annese, V. et al. Nifedipine and verapamil inhibit the sigmoid colon myoelectric response to eating in healthy volunteers. Dis Colon Rectum 41, 377–380 (1998). https://doi.org/10.1007/BF02237495

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02237495

Key words

Search

Navigation