Abstract
Simultaneous recordings of gastric manometry andmyoelectrical activity were made in 10 patients withgastroparesis. Intravenous erythromycin (100 mg) wasadministered in the fasting state for a period of 30 min. Subcutaneous injection of octreotide(100 μg) was administered before one of the fouridentical test meals. It was found that octreotidesignificantly decreased the antral motility index(30-min fasting: 4.51 ± 1.04 vs 1.75 ±0.97, P < 0.02; 60-min fed: 5.16 ± 1.44 vs 3.4± 1.41, P < 0.05) and the dominant power ofthe EGG (fasting power: 35.19 ± 1.54 vs 30.84± 1.57 dB, P < 0.004; postprandial powerincrease: 5.52 ± 1.06 vs 0.27 ± 0.87, P< 0.001). Erythromycin significantly increased theantral motility index (3.16 ± 0.96 vs 9.5± 0.61, P < 0.001) and the dominant power ofthe EGG (28.86 ± 1.57 dB vs 33.55 ± 1.59dB, P < 0.005) in the fasting state. An improvement in theregularity of the gastric slow wave was also noted witherythromycin. It was concluded that: (1) the inhibitoryeffect of octreotide on postprandial gastric motility and myoelectrical activity suggests thatcaution should be exercised when octreotide is used inpatients with gastroparesis; and (2) the stimulatoryeffect of erythromycin on gastric myoelectrical activity may enhance gastric motility and gastricemptying in patients with gastroparesis.
Similar content being viewed by others
REFERENCES
Mozwecz H, Pavel D, Pitrak D, Orellana P, Schlesinger PK, Layden TJ: Erythromycin stearate as prokinetic agent in postvagotomy gastroparesis. Dig Dis Sci 35:902–905, 1990
Urbain ILC, Vantrappen G, Janssens J, Vancutsem E, Peeters T, Deroo M: Intravenous erythromycin dramatically accelerate s gastric emptying in gastroparesis diabeticorum and normals and abolishes the emptying discrimination between solids and liquids. J Nucl Med 31:1490–1493, 1990
Janssens J, Peeters TL, Vantrappen G, Tack J, Urbain J, DeRoo M, Muls E, Bouillon R: Improvement of gastric emptying in diabetic gastroparesis by erythromycin — preliminary studies. N Engl J Med 322:1028–1031, 1990
Fraser R, Shearer T, Fuller J, Horowitz M, Dent J: Intravenous erythromycin overcomes small intestinal feedback on antral, pyloric, and duodenal motility. Gastroenterol 103:114–119, 1992
Annese V, Janssens J, Vantrappen G, Tack J, Peters TL, Willemse P, VanCutsem E: Erythromycin accelerates gastric emptying by inducing antral contractions and improved gastroduodenal coordination. Gastroenterology 102:823–828, 1992
Chen J, Yeaton P, McCallum RW: Effect of erythromycin on gastric myoele ctrical activity in normal human subjects. Am J Physiol 263:G24–G28, 1992
Harris AG: Somatostatin and somatostatin analogues: Pharmacokinetics and pharmacodynamic effects. Gut 35( suppl 3):S1–S4, 1994
Owyang C: Octreotide in gastrointestinal motility disorders. Gut 35(suppl 3):S11–S14, 1994
Haruma K, Wiste JA, Camilleri M: Effect of octreotide on gastrointe stinal pressure profiles in health and in functional organic gastrointestinal disorders. Gut 35:1064–1069, 1994
Richards WO, Geer R, O'Dorisio TK: Octreotide acetate induces fasting small bowel motility in patients with dumping syndrome. J Surg Res 49:438–487, 1990
Soudah HC, Hasler WL, Owang C: Effect of octreotide on intestinal motility and bacterial overgrowth in sleroderma. N Engl J Med 325:1461–1469, 1991
Peeters TL, Janssens J, Vantrappen G: Somatostatin and the interdigestive migrating motor complex in man. Regul Pept 5:209–217, 1983
Fuessl HS, Carolan G, Williams G, Bloom SR: Effect of long acting somatostatin analogue (SMS 201-995) on postprandial gastric emptying of 99mTc-tin colloid and mouth to cecum transit time in man. Digestion 36:101–107, 1987
Neri M, Cuccurallo F, Marzio L: Effects of somatostatin on gallbladde r volume and small intestinal motor activity in humans. Gastroenterology 98:316–321, 1990
Chen J: A computerized data analysis system for electrogastrogram. Comp Biol Med 22:45–58, 1992
Smout AJPM, van der Schee EJ, Grashuis JL: What is measured in electrogastrography? Dig Dis Sci 25:179–187, 1980
Familoni BO, Bowes KL, Kingma YJ, Cote KR: Can transcutaneous recordings detect gastric electrical abnormalities? Gut 32:141–146, 1991
Chen J, Schirmer BD, McCallum RW: Serosal and cutaneous recordings of gastric myoelectrical activity in patients with gastroparesis. Am J Physiol 266:G90–G98, 1994
Chen J, Richards RD, McCallum RW: Identification of gastric contractions from the cutaneous electrogastrogram. Am J Gastroente rol 89:79–85, 1994
Sun WM, Smout A, Malbert C, Edelbroek L, Jones K, Dent J, Horowitz M: Relationship between surface electrogastrography and antropyloric pressure. Am J Physiol 31:G424–G430, 1995
Chen JDZ, Stewart WR, McCallum RW: Spectral analysis of episodic rhythm variations in the cutaneous electrogastrogram. IEEE Trans Biomed Eng 40:128–134, 1993
Chen J, McCallum RW: Gastric slow wave abnormalities in patients with gastroparesis. Am J Gastroenterol 87:477–482, 1992
Camilleri M, Brown ML, Malagelada J-R: Relationship between impaired gastric emptying and abnormal gastrointestinal motility. Gastroente rology 91:94–99, 1986
Bortolotti M, Sarti P, Barara L, Brunelli F: Gastric myoelectrical activity in patients with chronic idiopathic gastroparesis. J Gastrointest Motil 2:104–108, 1990
Koch KL, Stern RM, Stewart WR, Vasey MW: Gastric emptying and gastric myoelectrical activity in patients with diabetic gastroparesis: Effect of long-term domperidone treatment. Am J Gastroenterol 84:1069–1075, 1989
Abell TL, Camilleri M, Hench VS, Malagelada J-R: Gastric electromechanical function and gastric emptying in diabetic gastroparesis. Eur J Gastroenterol Hepatol 3:163–167, 1991
Rothstein RD, Alavi A, Reynolds JC: Electrogastrography in patients with gastroparesis and effect of long-time cisapride. Dig Dis Sci 38:1518–1524, 1993
Chen J, Lin ZY, McCallum RW: Abnormal gastric myoelectrical activity and delayed gastric emptying in patients with symptoms suggestive of gastroparesis. Dig Dis Sci 41:1538–1545, 1996
Holle GE, Steinbach E, Forth W: Effects of erythromycin in the dog upper gastrointestinal tract. Am J Physiol 263:G52–G59, 1992
Geldof H, van der Schee EJ, Grashuis JL: Electrogastrographic characteristics of interdigestive migrating complex in humans. Am J Physiol 250:G165–G171, 1986
Abell TL, Malagelada J-R: Electrogastrography: current assessments and future perspective. Dig Dis Sci 83:806–811, 1988
Chen J, McCallum RW (eds). Electrogastrography: Principles and Applications. New York, Raven Press, 1994, pp 127–153
Stern RM, Koch KL, Stewart WR, Vasey MW: Electrogastrography: current issues in validation and methodology. Psychophysiology 24:55–64, 1987
Parkman HP, Harris AD, Miller MA, Fisher RW: Influence of age, gender, and menstrual cycle on the normal electrogastrogram. Am J Gastroenterol 91(1):127–133, 1996
Hasler WL, Soudah HC, Dulai G, Owyang C: Mediation of hyperglycemia-evoked gastric slow wave dysrhythmias by endogenous prostaglandin. Gastroenterology 108:727–736, 1995
Kim CH, Azpiroz F, Malagelada J-R: Characteristics of spontaneous and drug-induced gastric dysrhythmias in a chronic canine mode l. Gastroenterology 90:421–427, 1986
Cucchiara S, Minella R, Riezzo G, Vallone G, Vallone P, Castellone F, Auricchio S: Reversal of gastric electrical dysrhythmias by cisapride in children with functional dyspepsia. Dig Dis Sci 37:1136–1140, 1992
Riezzo G, Cucchiara S, Chiloiro M, Minella R, Guerra V, Giorgio I: Gastric emptying and myoelectrical activity in children with nonulcer dyspepsia. Effect of cisapride. Dig Dis Sci 40(7):1428–1434, 1995
Jebbink RJ, Samsom M, Bruijs PP, Bravenboer B, Akkermans LM: Hyperglycemia induces abnormalities of gastric myoelectrical activity in patients with type I diabetes mellitus. Gastroenterology 107( 5):1390–1397, 1994
Rights and permissions
About this article
Cite this article
Chen, J.D.Z., Lin, Z.Y., Edmunds, M.C. et al. Effects of Octreotide and Erythromycin on Gastric Myoelectrical and Motor Activities in Patients with Gastroparesis. Dig Dis Sci 43, 80–89 (1998). https://doi.org/10.1023/A:1018876021156
Issue Date:
DOI: https://doi.org/10.1023/A:1018876021156