Digestive Diseases and Sciences

, Volume 43, Issue 1, pp 80–89 | Cite as

Effects of Octreotide and Erythromycin on Gastric Myoelectrical and Motor Activities in Patients with Gastroparesis

  • J. D. Z. Chen
  • Z. Y. Lin
  • M. C. Edmunds
  • R. W. Mccallum
Article

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.

OCTREOTIDE ERYTHROMYCIN GASTRIC MANOMETRY GASTRIC MYOELECTRIC ACTIVITY GASTROPARESIS 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. 1.
    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, 1990Google Scholar
  2. 2.
    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, 1990Google Scholar
  3. 3.
    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, 1990Google Scholar
  4. 4.
    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, 1992Google Scholar
  5. 5.
    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, 1992Google Scholar
  6. 6.
    Chen J, Yeaton P, McCallum RW: Effect of erythromycin on gastric myoele ctrical activity in normal human subjects. Am J Physiol 263:G24–G28, 1992Google Scholar
  7. 7.
    Harris AG: Somatostatin and somatostatin analogues: Pharmacokinetics and pharmacodynamic effects. Gut 35( suppl 3):S1–S4, 1994Google Scholar
  8. 8.
    Owyang C: Octreotide in gastrointestinal motility disorders. Gut 35(suppl 3):S11–S14, 1994Google Scholar
  9. 9.
    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, 1994Google Scholar
  10. 10.
    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, 1990Google Scholar
  11. 11.
    Soudah HC, Hasler WL, Owang C: Effect of octreotide on intestinal motility and bacterial overgrowth in sleroderma. N Engl J Med 325:1461–1469, 1991Google Scholar
  12. 12.
    Peeters TL, Janssens J, Vantrappen G: Somatostatin and the interdigestive migrating motor complex in man. Regul Pept 5:209–217, 1983Google Scholar
  13. 13.
    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, 1987Google Scholar
  14. 14.
    Neri M, Cuccurallo F, Marzio L: Effects of somatostatin on gallbladde r volume and small intestinal motor activity in humans. Gastroenterology 98:316–321, 1990Google Scholar
  15. 15.
    Chen J: A computerized data analysis system for electrogastrogram. Comp Biol Med 22:45–58, 1992Google Scholar
  16. 16.
    Smout AJPM, van der Schee EJ, Grashuis JL: What is measured in electrogastrography? Dig Dis Sci 25:179–187, 1980Google Scholar
  17. 17.
    Familoni BO, Bowes KL, Kingma YJ, Cote KR: Can transcutaneous recordings detect gastric electrical abnormalities? Gut 32:141–146, 1991Google Scholar
  18. 18.
    Chen J, Schirmer BD, McCallum RW: Serosal and cutaneous recordings of gastric myoelectrical activity in patients with gastroparesis. Am J Physiol 266:G90–G98, 1994Google Scholar
  19. 19.
    Chen J, Richards RD, McCallum RW: Identification of gastric contractions from the cutaneous electrogastrogram. Am J Gastroente rol 89:79–85, 1994Google Scholar
  20. 20.
    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, 1995Google Scholar
  21. 21.
    Chen JDZ, Stewart WR, McCallum RW: Spectral analysis of episodic rhythm variations in the cutaneous electrogastrogram. IEEE Trans Biomed Eng 40:128–134, 1993Google Scholar
  22. 22.
    Chen J, McCallum RW: Gastric slow wave abnormalities in patients with gastroparesis. Am J Gastroenterol 87:477–482, 1992Google Scholar
  23. 23.
    Camilleri M, Brown ML, Malagelada J-R: Relationship between impaired gastric emptying and abnormal gastrointestinal motility. Gastroente rology 91:94–99, 1986Google Scholar
  24. 24.
    Bortolotti M, Sarti P, Barara L, Brunelli F: Gastric myoelectrical activity in patients with chronic idiopathic gastroparesis. J Gastrointest Motil 2:104–108, 1990Google Scholar
  25. 25.
    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, 1989Google Scholar
  26. 26.
    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, 1991Google Scholar
  27. 27.
    Rothstein RD, Alavi A, Reynolds JC: Electrogastrography in patients with gastroparesis and effect of long-time cisapride. Dig Dis Sci 38:1518–1524, 1993Google Scholar
  28. 28.
    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, 1996Google Scholar
  29. 29.
    Holle GE, Steinbach E, Forth W: Effects of erythromycin in the dog upper gastrointestinal tract. Am J Physiol 263:G52–G59, 1992Google Scholar
  30. 30.
    Geldof H, van der Schee EJ, Grashuis JL: Electrogastrographic characteristics of interdigestive migrating complex in humans. Am J Physiol 250:G165–G171, 1986Google Scholar
  31. 31.
    Abell TL, Malagelada J-R: Electrogastrography: current assessments and future perspective. Dig Dis Sci 83:806–811, 1988Google Scholar
  32. 32.
    Chen J, McCallum RW (eds). Electrogastrography: Principles and Applications. New York, Raven Press, 1994, pp 127–153Google Scholar
  33. 33.
    Stern RM, Koch KL, Stewart WR, Vasey MW: Electrogastrography: current issues in validation and methodology. Psychophysiology 24:55–64, 1987Google Scholar
  34. 34.
    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, 1996Google Scholar
  35. 35.
    Hasler WL, Soudah HC, Dulai G, Owyang C: Mediation of hyperglycemia-evoked gastric slow wave dysrhythmias by endogenous prostaglandin. Gastroenterology 108:727–736, 1995Google Scholar
  36. 36.
    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, 1986Google Scholar
  37. 37.
    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, 1992Google Scholar
  38. 38.
    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, 1995Google Scholar
  39. 39.
    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, 1994Google Scholar

Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • J. D. Z. Chen
  • Z. Y. Lin
  • M. C. Edmunds
  • R. W. Mccallum

There are no affiliations available

Personalised recommendations