Effect of tolterodine on gastrointestinal transit and bowel habits in healthy subjects

Bharucha, Adil E.; Seide, Barbara M.; Guan, Zhonghong; Andrews, Christopher N.; Zinsmeister, Alan R.

doi:10.1111/j.1365-2982.2008.01089.x

Cited by 18 publications

(18 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If confirmed in prospective studies of transit and simultaneous symptom measurement, this may lead to better designed treatments that inhibit postprandial responses such as 5-HT 3 antagonists (7,47) and selective muscarinic antagonists (26,27). …”

Section: Discussionmentioning

confidence: 91%

“…The cholinergic mechanisms involved in increased ileocecal transit have been investigated in a canine model of the ileocolonic region in vivo, with evidence for involvement of muscarinic M 1 and M 3 mechanisms (26,27). If symptoms are aggravated postprandially in IBS, these data suggest that further studies of selective antimuscarinic agents in patients with IBS are indicated.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Meal Ingestion on Ileocolonic and Colonic Transit in Health and Irritable Bowel Syndrome

et al. 2009

View full text Add to dashboard Cite

Background Postprandial symptoms in irritable bowel syndrome (IBS) have been associated with increased bowel contractility. Aim To compare ileocolonic and colonic responses to feeding in health and IBS. Methods We prospectively analyzed data from separate research trials in122 IBS patients and 41 healthy volunteers. Ileocolonic transit (ICT) was evaluated before [colonic filling (CF)3h] and immediately after (CF4h) a standard lunch at 3h45min, and 2h thereafter. Colonic geometric center (GC) was calculated 2h (GC6h) after lunch ingested at 4h (GC4h) and directly after (GC8h) a standard dinner ingested at 7h45min. Results ICT immediately after eating was higher in IBS-D than health (23.1±2.4% vs. 17.5±2.8%, p=0.059). ICT 2h after lunch was similar between groups (p=0.55). There was significant overall group difference in colonic transit 2h post-lunch (p=0.045), particularly in IBS-C (GC6-GC4, Δ 0.29±0.08) vs. health (Δ 0.56±0.12 GC units). Conclusions After feeding, ICT is increased in IBS-D, whereas colonic transit is blunted in IBS-C.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Effect of Meal Ingestion on Ileocolonic and Colonic Transit in Health and Irritable Bowel Syndrome

et al. 2009

View full text Add to dashboard Cite

show abstract

“…GE was assessed by scintigraphy using a 300-kcal mixed meal containing 99m Tc-sulfur colloid labeled eggs in all patients [6]. For our laboratory, normal values for GE are 11–39% at 1 hr, 40–76% at 2 hr, and 84–98% at 4 hr.…”

Section: Methodsmentioning

confidence: 99%

Gastric emptying in postural tachycardia syndrome: a preliminary report

et al. 2013

View full text Add to dashboard Cite

Purpose Autonomic neuropathy is widely recognized to be associated with upper gastrointestinal symptoms and abnormal (i.e., rapid or slow) gastric emptying. While patients with postural orthostatic tachycardia syndrome (POTS) may also have gastrointestinal symptoms, our understanding of gastric emptying disturbances in POTS is very limited. The objectives of this study were to evaluate the relationship between gastric emptying disturbances and gastrointestinal symptoms in patients with POTS. Methods . We retrospectively reviewed the medical records of 22 well-characterized patients with POTS and upper gastrointestinal symptoms in whom autonomic (i.e., postganglionic sudomotor, cardiovagal, and adrenergic) functions and gastric emptying were evaluated using standardized techniques and scintigraphy respectively. Medical records were reviewed retrospectively to assess clinical features, gastric emptying, and autonomic functions. Results Over 70% of patients had nausea and/or vomiting, which was the most common GI symptom; other common symptoms were abdominal pain (59%), bloating (55%), and postprandial fullness/early satiety (46%). Over one-third of patients had abnormal (i.e., rapid [27%] or delayed [9%]) gastric emptying. Gastric emptying disturbances were not significantly associated with GI symptoms, autonomic symptoms or autonomic dysfunction. Conclusions Over one third of patients with POTS and gastrointestinal symptoms have abnormal, more frequently rapid than delayed gastric emptying. These findings need to be confirmed in a larger cohort of patients.

show abstract

“…Obesity is a risk factor for diarrhea [14] and accelerated colonic transit [15]. Besides predisposing to acute leakage by virtue of higher viscus (bladder or rectal) pressure, it is suggested that a higher intra-abdominal pressure may damage the pelvic floor in obese people [9].…”

mentioning

confidence: 99%

Incontinence: An Underappreciated Problem in Obesity and Bariatric Surgery

Bharucha

2010

Dig Dis Sci

View full text Add to dashboard Cite

Driven by the obesity epidemic, the number of bariatric operations performed in the United States has increased markedly, by one estimate from *20,000 in 1998 to 140,000 in 2004, and plateaued thereafter [1]. While diarrhea is a recognized consequence of intestinal bypass procedures, Roberson and colleagues in this issue of the journal highlight, for the first time, that fecal incontinence (FI) may begin or worsen after bariatric surgery [2]. Of note, 48% of women and 42% of men reported FI for liquid stools while 21% of women and 30% of men reported solid FI after surgery. Moreover, 55% of women and 31% of men reported their symptoms were worse after surgery. While these figures may be affected by response rates (48%) or, since surveys were only conducted after surgery, by recall bias, they draw attention for the first time to an underappreciated and significant problem since FI can be a devastating symptom which can substantially impair quality of life [3,4].Consistent with studies in the general population, diarrhea, cholecystectomy, stress, and mixed urinary incontinence were risk factors for FI by univariate analysis [5,6]. However, only diarrhea remained a significant risk factor in multivariate analysis. The high prevalence of FI, not only in women but also in men, who are less prone to pelvic floor injury, also underscores the contribution of diarrhea. Stool consistency is a critical factor affecting fecal continence. Indeed, even healthy subjects find it harder to retain continence for low-viscosity (i.e., 100 cPois) than highviscosity material (10,000 cPois) in the rectum, particularly when anal sphincter endurance is reduced [7]. In addition to fat malabsorption resulting from biliopancreatic diversion, an alteration in intestinal and colonic bacterial flora after bariatric surgery may also contribute to diarrhea [8].Obesity is a risk factor for urinary incontinence [9]. Moreover, in a large trial of 338 obese women with urinary incontinence, a 6-month structured weight loss program was more effective than education alone for weight loss (i.e., average weight loss of 8% body weight for treatment versus 1.6% for control group) and reducing the frequency of urinary incontinence (47.4 vs. 28.1%) [10]. This benefit was more pronounced for stress than urge urinary incontinence and supports the concept that obesity predisposes one to urinary incontinence. In the Roberson study, urinary incontinence improved in one-third of patients after bariatric surgery; whether this improvement was related to actual weight loss is unclear. In contrast to urinary incontinence, the relationship between obesity per se (i.e., before bariatric surgery) and FI is less clearly defined. In one study of 256 morbidly obese (BMI C 35 kg/m 2 ) women, the prevalence of anal incontinence (i.e., gas and stool) was 67%, which seems very high [11]. The BMI was not a risk factor for anal incontinence in that study, perhaps because all women were morbidly obese. However, it is difficult to compare this figure to population-based estimates,...

show abstract

Effect of tolterodine on gastrointestinal transit and bowel habits in healthy subjects

Cited by 18 publications

References 29 publications

Effect of Meal Ingestion on Ileocolonic and Colonic Transit in Health and Irritable Bowel Syndrome

Effect of Meal Ingestion on Ileocolonic and Colonic Transit in Health and Irritable Bowel Syndrome

Gastric emptying in postural tachycardia syndrome: a preliminary report

Incontinence: An Underappreciated Problem in Obesity and Bariatric Surgery

Contact Info

Product

Resources

About