Effect of a proton pump inhibitor on postprandial gastric volume, emptying and symptoms in healthy human subjects: a pilot study

Grudell, April; Camilleri, Michael; Burton, Duane D.; Stephens, Debra

doi:10.1111/j.1365-2036.2006.03102.x

Cited by 19 publications

(16 citation statements)

References 32 publications

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“…This inhibition of gastric emptying caused by rabeprazole is consistent with some previous studies using PPI (Benini et al 1996;Rasmussen et al 1997Rasmussen et al , 1999Parkman et al 1998;Anjiki et al 2005;Tougas et al 2005;Takahashi et al 2006), but at variance with others that failed to show any association between PPI administration and gastric emptying (Vidon et al 1993;Jones et al 2003;Grudell et al 2006). It has been supposed that such discrepancies may be partly explained by the use of different meal compositions and forms, and by the different methods for evaluating gastric emptying.…”

Section: Discussionsupporting

confidence: 76%

“…Although there have been conflicting reports on PPI and gastric emptying, significant studies reported delayed gastric emptying by PPI administration (Benini et al 1996;Rasmussen et al 1997Rasmussen et al , 1999Parkman et al 1998;Anjiki et al 2005;Tougas et al 2005;Takahashi et al 2006), while other studies failed to show any significant change in the gastric emptying by the treatment (Vidon et al 1993;Jones et al 2003;Grudell et al 2006). Since a sufficient amount of gastric acid is essential for the generation of luminal NO in the stomach originating from dietary nitrate (McKnight et al 1997;Iijima et al 2003), the effect of dietary nitrate on gastric emptying, if any, would be modified by co-administration of PPI.…”

mentioning

confidence: 99%

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Lack of Modulation of Gastric Emptying by Dietary Nitrate in Healthy Volunteers

Terai

Iijima

Asanuma

et al. 2009

Tohoku J. Exp. Med.

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Section: Discussionsupporting

confidence: 76%

mentioning

confidence: 99%

Lack of Modulation of Gastric Emptying by Dietary Nitrate in Healthy Volunteers

Terai

Iijima

Asanuma

et al. 2009

Tohoku J. Exp. Med.

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“…Anyway, the possibility remains that the peptic maldigestion is not the sole mechanism for the delayed emptying induced by PPIs. The last conflicting issue is that intragastric pH becomes high after meals even without PPIs, because a buffering effect of meals is substantial [27]. This fact suggests that the postprandial pH environment for the peptic activity may be the same whether PPIs are given or not.…”

Section: Impaired Peptic Digestionmentioning

confidence: 94%

“…Grudell et al [27] showed that rabeprazole did not significantly change pre and postprandial gastric volume. Vidon et al [18] demonstrated that lansoprazole only slightly decreased gastric fluid volume in the fasted state while it moderately suppressed a postprandial increment of the fluid volume: the mean difference in postprandial gastric volume between placebo and lansoprazole was about 100 ml at every sampling time during a 3-h study period.…”

Section: Changes Of Physical and Chemical Properties Of Ingestamentioning

confidence: 98%

Effects of Proton Pump Inhibitors on Gastric Emptying: A Systematic Review

2009

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The proton pump inhibitor (PPI) is widely used for the treatment of gastroesophageal reflux disease, peptic ulcer diseases, and functional dyspepsia. The pathogenesis of these acid-related and/or functional upper gastrointestinal disorders is potentially associated with abnormal gastric emptying. To date, variable effects of PPIs on gastric emptying have been reported. Therefore, it is relevant to gather and analyze published information on this topic. A systematic literature search has been performed, showing that the delaying effect of PPIs on gastric emptying of solid meals is consistent, whereas the effect of PPIs on the emptying of liquids is inconsistent. The underlying mechanisms whereby PPIs may affect gastric emptying have been discussed, most of which still remain hypothetic. Gastric emptying of solids involves a process of peptic hydrolysis. PPIs impair the hydrolytic digestion by inhibiting acid-dependent peptic activity, thereby delaying the solid emptying. Gastric emptying of liquids largely depends on volume and energy density of intragastric contents. PPIs variably modify the volume and the energy density by reducing gastric fluid secretion, thereby modifying the liquid emptying in an unpredictable manner. Hypergastrinemia has been considered to delay gastric emptying, but it seems of minor importance in the regulation of gastric emptying during PPI use. The delayed emptying of solids due to PPI therapy may have clinical implications in the management of gastroesophageal reflux disease, functional dyspepsia, as well as diabetes.

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“…In patients with FD, especially those with EPS, suppression of gastric acid secretion by antisecretory agents such as proton-pump inhibitors (PPIs) or histamine type 2-receptor antagonists (H 2 blocker) seems to ameliorate the epigastric pain or burning. Furthermore, even in PDS, as the initial gastric acid emptying may play a pathogenetic role on symptom generation through the early onset of duodenal brake, acid suppression might be effective, at least in part, against the bothersome postprandial fullness [Grudell et al 2006].…”

Section: Introductionmentioning

confidence: 99%

Proton-pump inhibitors for the treatment of functional dyspepsia

Suzuki

Okada

Hibi

2011

Therap Adv Gastroenterol

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In the Rome III classification, functional dyspepsia (FD) has been further subcategorized into two different syndromes, namely, epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS). Acid-related pathophysiology seems to be mainly responsible for EPS, and antisecretory agents such as proton-pump inhibitors (PPIs) seem to be effective mainly against EPS. However, recent information as to the relationship between initial duodenal acid sensitization in the early postprandial phase and delayed gastric emptying in the later postprandial phase would suggest the amelioration of PDS by antisecretory agents. In the present review, we summarized the recent literature on the direct and indirect effect of PPIs in FD (including not only Rome III, but also Rome II criteria). The effects of PPIs against FD are heterogeneous, depending on the protocol of the clinical studies, and the inclusion criteria of each randomized controlled trial (primary care or tertiary care population). As the placebo effects cannot be ignored in this disease, a placebo-controlled study would be necessary, at least for the evaluation of the effect of each agent on symptom relief in patients with FD. Further studies directly comparing PPIs with suitable placebos in terms of their effects in reducing the symptoms of endoscopically confirmed, Rome III-based FD are awaited.

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Effect of a proton pump inhibitor on postprandial gastric volume, emptying and symptoms in healthy human subjects: a pilot study

Abstract: SUMMARY BackgroundIn consensus guidelines, proton pump inhibitors (PPIs) are recommended for the treatment of functional dyspepsia. It is unclear whether PPIs change gastric volume or emptying.

Cited by 19 publications

References 32 publications

Lack of Modulation of Gastric Emptying by Dietary Nitrate in Healthy Volunteers

Lack of Modulation of Gastric Emptying by Dietary Nitrate in Healthy Volunteers

Effects of Proton Pump Inhibitors on Gastric Emptying: A Systematic Review

Proton-pump inhibitors for the treatment of functional dyspepsia

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