Erythromycin accelerates solid emptying at the expense of gastric sieving

Lin, Henry C.; Sanders, Sergio; Gu, Yu-Guo; Doty, Jeffrey E.

doi:10.1007/bf02090071

Cited by 47 publications

(10 citation statements)

References 22 publications

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“…Thus, they can be regarded as pharmacological components that "dodge" the inadequate vagal modulation of gastric activity or replace the missing central control over the stomach. Such direct action may also explain why in some circumstances, as with erythromycin, a dosage with minor potency in healthy subjects may exhibit a kind of pharmacologically induced "dumping" in some cases via the induction of premature fasting motor pattern at the expense of gastric sieving (33). This may also be the consequence of the missing or defective central nervous modulation.…”

Section: An Appropriate Strategy For Treatmentmentioning

confidence: 93%

Pathophysiology of Diabetic Gastroparesis

Enck

Frieling²

1997

Diabetes

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Our understanding of the nature of diabetic gastroparesis has advanced in the last decade due to new investigational procedures (electrogastrography, visceral evoked potential recording), and transferring these insights into clinical routine will be our task in the future. Meanwhile, the clinical relevance of gastroparesis--whether overt or silent--remains unquestioned: proper gastric emptying is a prerequisite for adequate metabolic control, and its disturbance may result not only in further progression of the chronic complications of the disease, but also in the false assumption that these patients are not compliant with their doctor's management--the patients just may have delayed emptying of their stomach without noticing it.

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Section: An Appropriate Strategy For Treatmentmentioning

confidence: 93%

Pathophysiology of Diabetic Gastroparesis

Enck

Frieling²

1997

Diabetes

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“…The intense motility that is induced by this drug impairs gastric sieving, promot ing the delivery of poorly triturated food residue into the duodenum. 110 Oral pill, liquid and intravenous forms of this agent can be prescribed. Symptom reduc tions have been reported in controlled and openlabel studies.…”

Section: Prokinetic Medicationsmentioning

confidence: 99%

Gastroparesis: pathogenesis, diagnosis and management

Hasler

2011

Nat Rev Gastroenterol Hepatol

103

110

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Gastroparesis is a prevalent condition that produces symptoms of delayed gastric emptying in the absence of physical blockage. The most common etiologies of gastroparesis are idiopathic, diabetic, and postsurgical disease, although some cases stem from autoimmune, paraneoplastic, neurologic or other conditions. Histologic examination of gastric tissues from patients with severe gastroparesis reveals heterogeneous and inconsistent defects in the morphology of enteric neurons, smooth muscle and interstitial cells of Cajal, and increased levels of inflammatory cells. Diagnosis is most commonly made by gastric emptying scintigraphy; however, wireless motility capsules and nonradioactive isotope breath tests have also been validated. A range of treatments have been used for gastroparesis including dietary modifications and nutritional supplements, gastric motor stimulatory or antiemetic medications, endoscopic or surgical procedures, and psychological interventions. Most treatments have not been subjected to controlled testing in patients with gastroparesis. The natural history of this condition is poorly understood. Active ongoing research is providing important insights into the pathogenesis, diagnosis, treatment and outcomes of this disease.

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“…However, this potent prokinetic effect can impair gastric sieving of solids leading to duodenal delivery of abnormally large food particles with consequent fat malabsorption [68]. Erythromycin can be taken in pill, liquid and intravenous forms.…”

Section: Erythromycinmentioning

confidence: 99%

Management of gastroparesis

Hasler

2008

Expert Review of Gastroenterology & Hepatology

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Gastroparesis presents with nausea, vomiting, early satiety and abdominal discomfort, as well as a range of nongastrointestinal manifestations in association with delays in gastric emptying. The disorder may be a consequence of systemic illnesses, such as diabetes mellitus, occur as a complication of gastroesophageal surgery or develop in an idiopathic fashion and may mimic other disorders with normal gastric emptying. Some cases of idiopathic gastroparesis present after a viral infection. Management relies primarily on therapies that accelerate gastric emptying or reduce vomiting, although endoscopic or surgical options are available for refractory cases. Current research is focusing on the cellular and molecular mechanisms underlying development of delayed gastric emptying, as well as factors unrelated to motor dysfunction that may elicit some symptoms. Future pharmaceuticals will target the contractile and nonmotor defects via novel pathways. Novel electrical stimulation techniques will be employed either alone or in combination with medications.

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Erythromycin accelerates solid emptying at the expense of gastric sieving

Cited by 47 publications

References 22 publications

Pathophysiology of Diabetic Gastroparesis

Pathophysiology of Diabetic Gastroparesis

Gastroparesis: pathogenesis, diagnosis and management

Management of gastroparesis

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