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Effects of tegaserod and erythromycin in upper gut dysmotility: a comparative study

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Abstract

Objectives

Tegaserod may enhance upper gut transit, but, its prokinetic effects on antral/small bowel motility and how this compares with erythromycin is unknown. We prospectively assessed and compared the effects of tegaserod and erythromycin on upper gut motility.

Methods

In an open label, non-crossover study, 22 patients (M/F=4/18; mean age=37 years) with symptoms of upper gut dysmotility underwent 24-hour ambulatory antroduodenojejunal manometry with a six-sensor solid state probe. The effects of 12 mg oral tegaserod were compared with 125 mg intravenous erythromycin by quantifying pressure wave activity and assessing motor patterns.

Results

Motor activity increased (p<0.05) in antrum, duodenum and jejunum with both drugs when compared to baseline period. The motor response with tegaserod was higher (p<0.05) in jejunum and occurred during the second or third hours, whereas with erythromycin, it was higher (p<0.05) in antrum and occurred within 30 minutes. After tegaserod, a ‘fed-response’ like pattern was seen whereas after erythromycin, large amplitude (>100 mmHg) antral contractions at 3 cycles per minute were seen. Following tegaserod and erythromycin, phase III MMCs occurred in 12 (55%) and 8 (36%) patients respectively (p>0.05).

Conclusions

Both drugs increase upper gut motility and induce MMC’s, but exert a differential response. Tegaserod produces a more sustained prokinetic effect in the duodenum/jejunum, whereas erythromycin predominantly increases antral motor activity.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA

    Issam Nasr, Satish S. C. Rao, Ashok Attaluri, Syed M. A. Hashmi & Robert Summers

Authors
  1. Issam Nasr
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  2. Satish S. C. Rao
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  3. Ashok Attaluri
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  4. Syed M. A. Hashmi
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  5. Robert Summers
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Corresponding author

Correspondence to Satish S. C. Rao.

Additional information

Portions of this work were presented at Digestive Disease Week 2006 and published as abstracts; Gastroenterology, 2006, 130:4,S2:W1851; Gastroenterology, 2006, 130:4,S2:M2208.

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Nasr, I., Rao, S.S.C., Attaluri, A. et al. Effects of tegaserod and erythromycin in upper gut dysmotility: a comparative study. Indian J Gastroenterol 28, 136–142 (2009). https://doi.org/10.1007/s12664-009-0048-6

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  • DOI: https://doi.org/10.1007/s12664-009-0048-6

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