Digestive Diseases and Sciences

, Volume 31, Issue 3, pp 241–246 | Cite as

Colonic motility and gastric emptying in patients with irritable bowel syndrome effect of pretreatment with octylonium bromide

  • Francesco Narducci
  • Gabrio Bassotti
  • Maria Teresa Granata
  • Maria Antonia Pelli
  • Manuela Gaburri
  • Renato Palumbo
  • Antonio Morelli
Original Articles

Abstract

This study was undertaken to evaluate (1) the colonic response to eating for a prolonged time in healthy subjects and patients with the irritable bowel syndrome (IBS); (2) the effect of octylonium bromide, a new smooth muscle relaxant acting by interfering with calcium ion mobilization, on the postprandial colonic motility; and (3) whether chronic gastric stasis could be responsible for both the dyspeptic symptoms often complained of by IBS patients and the faulty colonic response to eating. The colonic response to a 1000-kcal mixed meal in ten healthy subjects was characterized by two transient (from 0 to 60 and from 120 to 150 min postprandially, respectively) increases in colonic motor activity; ten IBS patients showed a continuous postprandial increase in colonic motor activity that was not terminated 180 min after eating. Treatment of IBS patients with octylonium bromide (80 mg, qid,per os) for 5–7 days reduced their colonic response to eating to a very short increase in colonic motor activity limited to the first 30 min. Finally, gastric emptying was not different in the two groups.

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References

  1. 1.
    Connel AM, Jones F, Rowlands EN: Motility of the pelvic colon. Part IV Abdominal pain associated with colonic hypermotility after meals. Gut 6:105–112, 1965Google Scholar
  2. 2.
    Holdstock DJ, Misiewicz JJ, Waller SL: Observations on the mechanism of abdominal pain. Gut 10:19–31, 1969Google Scholar
  3. 3.
    Wangel AG, Deller DJ: Intestinal motility in man. III Mechanisms of constipation and diarrhea with particular reference to the irritable colon syndrome. Gastroenterology 48:69–84, 1965Google Scholar
  4. 4.
    Harvey RF, Read AE: Effect of cholecystokinin on colonic motility and symptoms in patients with the irritable-bowel syndrome. Lancet 1:1–3, 1973Google Scholar
  5. 5.
    Harvey RF, Read AE: Effects of oral magnesium sulphate on colonic motility in patients with the irritable bowel syndrome. Gut 14:983–987, 1973Google Scholar
  6. 6.
    Snape WJ, Carlson GM, Matarazzo SA, Cohen S: Evidence that abnormal myoelectric activity produces colonic motor dysfunction in the irritable bowel syndrome. Gastroenterology 72:383–387, 1977Google Scholar
  7. 7.
    Sullivan MA, Cohen S, Snape MJ: Colonic myoelectrical activity in irritable-bowel syndrome. Effect of eating and anticholinergics. N Engl J Med 298:878–883, 1978Google Scholar
  8. 8.
    Taylor I, Darby C, Hammond P, Basu P: Is there a myoelectrical abnormality in the irritable colon syndrome? Gut 19:391–395, 1978Google Scholar
  9. 9.
    Bueno L, Fioramonti J, Ruckebusch Y, Frexinos J, Coulom P: Evaluation of colonic myoelectrical activity in health and functional disorders. Gut 21:480–485, 1980Google Scholar
  10. 10.
    Whitehead WE, Engle BJ, Schuster MM: Irritable bowel syndrome. Physiological and psychological differences between diarrhea-predominant and constipation-predominant patients. Dig Dis Sci 25:404–413, 1980Google Scholar
  11. 11.
    Latimer P, Sarna S, Campbell D, Latimer M, Waterfall W, Daniel EE: Colonic motor and myoelectrical activity: A comparative study of normal subjects, psychoneurotic patients, and patients with irritable bowel syndrome. Gastroenterology 80:893–901, 1981Google Scholar
  12. 12.
    Sarna S, Latimer P, Campbell D, Watrefall WE: Effect of stress, meal and neostigmine on rectosigmoid electrical control activity in normals and in the irritable bowel syndrome patients. Dig Dis Sci 27:582–591, 1982Google Scholar
  13. 13.
    Snape WJ, Matarazzo SA, Cohen S: Effect of eating and gastrointestinal hormones on human colonic myoelectrical and motor activity. Gastroenterology 75:373–378, 1978Google Scholar
  14. 14.
    Wright SH, Snape WJ, Battle W, Cohen S, London RL: Effect of dietary components on gastrocolonic response. Gastrointest Liver Physiol 1:G228-G232, 1980Google Scholar
  15. 15.
    Misciewicz JJ, Connel AM, Pontes FA: Comparison of the effect of meals and prostigmine on the proximal and distal colon in patients with and without diarrhea. Gut 7:468–473, 1966Google Scholar
  16. 16.
    Battle WM, Cohen S, Snape MJ: Inhibition of postprandial colonic motility after ingestion of an amino acid mixture. Dig Dis Sci 25:647–652, 1980Google Scholar
  17. 17.
    Narducci F, Bassotti G, Pelli MA: Prolonged recording of myoelectric and contractile activities of the human colon. Gastroenterol 16:317, 1984Google Scholar
  18. 18.
    Murney RG, Winship DH: The irritable colon syndrome. Clin Gastroenterol 11:563–592, 1982Google Scholar
  19. 19.
    Fielding JF: The irritable bowel syndrome. Part I: Clinical spectrum. Clin Gastroenterol 6:607–622, 1977Google Scholar
  20. 20.
    Perkel MS, Moore C, Hersh T, Davidson ED: Metoclopramide theraphy in patients with delayed gastric emptying. Dig Dis Sci 24:662–666, 1979Google Scholar
  21. 21.
    You CH, Lee KY, Chey WY, Menguy R: Electrogastrographic study of patients with unexplained nausea, bloating, and vomiting. Gastroenterology 79:311–314, 1980Google Scholar
  22. 22.
    Rees WD, Miller LJ, Malagelada JR: Dyspepsia, antral motor dysfunction, and gastric stasis of solids. Gastroenterology 78:360–365, 1980Google Scholar
  23. 23.
    Milo R: Use of the peripheral dopamine antagonist, domperidone, in management of gastrointestinal symptoms in patients with irritable bowel syndrome. Curr Med Res Opin 6:577–584, 1980Google Scholar
  24. 24.
    Maggi CA, Grimaldi G, Volterra G, Meli A: Octylonium bromide: A new spasmolytic agent, devoid of atropine-like side effects. Drugs Exp Clin Res 3:235–242, 1983Google Scholar
  25. 25.
    Maggi CA, Meli A: Assessment of potential selectivity of antispasmodics for the various sections of the gastrointestinal tract of the rat as a guideline for their clinical use. Arch Int Pharmacodyn Ther 262:221–230, 1983Google Scholar
  26. 26.
    Narducci F, Granata MT, Morelli A, Barba A, Palumbo R: Evaluation of Tc-99m-sulfur colloid-tagged cooked egg whites as a marker of solid food in the human stomach. J Nucl Med All Sci 27:162–163, 1983Google Scholar
  27. 27.
    Nie NH, Hull CH, Jenkins JG, Steinbrenner K, Bent DH: Statistical Package for the Social Sciences. New York, McGraw-Hill, Book 1975Google Scholar
  28. 28.
    Kerlin P, Zinsmeister A, Phillips S: Motor response to food of the ileum, proximal colon and distal colon of healthy humans. Gastroenterology 84:762–770, 1983Google Scholar
  29. 29.
    Levison S, Bhasker M, Morin R, Snape WJ: Effects of intraluminal and intravenous nutrients on colonic motility. Gastroenterology 84:1229, 1983Google Scholar
  30. 30.
    Snape WJ, Carlson GM, Cohen S: Colonic myoelectric activity in the irritable bowel syndrome. Gastroenterology 70:326–330, 1976Google Scholar
  31. 31.
    Acharya A, Waite N, Howlett P, Tanner AR, Smith CL: Failure to demonstrate altered gastric emptying in irritable bowel syndrome. Dig Dis Sci 28:889–892, 1983Google Scholar
  32. 32.
    Snape WJ, Wright SA, Battle WM, London R, Sun EA, Cohen S: Successful treatment of the irritable colon syndrome with high doses of an anticholinergic. Gastroenterology 80:1289, 1981Google Scholar
  33. 33.
    Ivey KJ: Are anticholinergics of use in the irritable colon syndrome? Gastroenterology 68:1300–1307, 1975Google Scholar
  34. 34.
    Maggi CA, Manzini S, Meli A: Octylonium bromide: A smooth muscle relaxant which interferes with calcium ions mobilization. Arch Int Pharmacodyn Ther 264:305–323, 1983Google Scholar
  35. 35.
    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 80:317–319, 1985Google Scholar
  36. 36.
    Blume M, Schuster M, Tucker H: Effect of nifedipine on colonic motility in the irritable bowel syndrome. Gastroenterology 84:1109, 1983Google Scholar
  37. 37.
    Signorini C, Tosoni S, Ballerini R, Mannucci C: A study of the absorption of octilonium bromide following oral administration in man. Drug Exp Clin Res 4:273–276, 1984Google Scholar
  38. 38.
    Baldi F, Ferrarini F, Milazzo G, Casson M, Balestra R, Angeloni M: Effect of locally administered octylonium bromide on stimulated antral and sigmoid motility in humans. International Meeting on GI Motility, F Villardel, A Benales (eds). Madrid, Cryre, 1983, p 98Google Scholar

Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • Francesco Narducci
    • 1
    • 2
  • Gabrio Bassotti
    • 1
    • 2
  • Maria Teresa Granata
    • 1
    • 2
  • Maria Antonia Pelli
    • 1
    • 2
  • Manuela Gaburri
    • 1
    • 2
  • Renato Palumbo
    • 1
    • 2
  • Antonio Morelli
    • 1
    • 2
  1. 1.Department of Internal Medicine, Gastrointestinal UnitUniversity of PerugiaItaly
  2. 2.Department of Nuclear MedicineUniversity of PerugiaItaly

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