Gastric emptying is not prolonged in obese patients

Buchholz, Vered; Berkenstadt, Haim; Goitein, David; Dickman, Ram; Bernstine, Hanna; Rubin, Moshe

doi:10.1016/j.soard.2012.03.008

Cited by 53 publications

(27 citation statements)

References 13 publications

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“…The transit time of a dosage form through different segments of the gastrointestinal tract depends on factors such as gastric emptying rate and flow rate, and can vary considerably, intraindividually and interindividually 18. Obese patients have a normal gastric emptying 19. Values for residence time in the stomach in humans in both the fasted and non-fasted state, as reported in the literature, vary.…”

Section: Discussionmentioning

confidence: 98%

A gastrointestinal simulation system for dissolution of oral solid dosage forms before and after Roux-en-Y gastric bypass

et al. 2018

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BackgroundThe Roux-en-Y gastric bypass (RYGB) is a bariatric procedure, greatly reducing the stomach size and bypassing the duodenum and proximal jejunum. Hence, RYGB may reduce the absorption and bioavailability of oral medication. For clinical decisions on the use of medication, knowledge of altered modifications in drug disposition is a prerequisite. An in vitro dissolution method for solid oral medications, simulating conditions before and after RYGB, might be a valuable tool to predict the pharmaceutical availability of medicines frequently used by patients after RYGB.ObjectivesTo develop a gastrointestinal simulation system (GISS), mimicking conditions before and after RYGB for investigating dissolution characteristics of solid oral medications, and to assess the pharmaceutical availability of metoprolol from immediate-release (IR) and controlled-release (CR) tablets under these conditions.MethodsWith an adjusted, pharmacopoeial paddle dissolution apparatus, the GISS enables variation in parameters which are relevant to drug release in vivo: pH, volume, residence time, osmolality and agitation. Metoprolol tartrate 100 mg IR tablets and metoprolol CR tablets were tested. Release profiles were determined by measuring the concentrations of metoprolol spectrophotometrically.ResultsFrom IR tablets, under all conditions applied, >85% of metoprolol was released within 25 min. From all tested CR tablets >90% of metoprolol was released after 22 hours.ConclusionsThis GISS is a suitable dissolution system to assess pharmaceutical availability before and after RYGB. In patients who have undergone RYGB, no problems in pharmaceutical availability of metoprolol IR and CR tablets are to be expected. Any changes in response to metoprolol in patients after RYGB should therefore be ascribed to changes in bioavailability.

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Section: Discussionmentioning

confidence: 98%

A gastrointestinal simulation system for dissolution of oral solid dosage forms before and after Roux-en-Y gastric bypass

et al. 2018

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“…46 29.610 Prospective cohort Symptom score 84 months Weight loss is associated with a reduction in GERD symptoms in a dose-depend mechanism 47 17 noticed; some studies show a delayed emptying, whereas others do not. 34,35 Diaphragm. The diaphragm crus helps to prevent GERD by pinching the distal esophagus during moments of increased abdominal pressure, such as cough or bending.…”

Section: Pathophysiologymentioning

confidence: 99%

Gastroesophageal reflux disease in the obese: Pathophysiology and treatment

Nadaleto

Herbella

Patti

2016

Surgery

125

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“…Recent literature suggests that gastric emptying is not impaired in the obese and is not a primary player in aspiration risk. 79 The increase in GERD occurs particularly in patients with elevated abdominal fat mass, and obesity is also associated with greater risk of hiatal hernia. 80 The function of the esophageal sphincters under anesthesia has been investigated in a study of obese and non-obese patients.…”

Section: Upper Gastrointestinal Function and Risk Of Aspiration Of Gamentioning

confidence: 99%

Perioperative management of the severely obese patient: a selective pathophysiological review

Cullen

Ferguson

2012

Can J Anesth/J Can Anesth

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Gastric emptying is not prolonged in obese patients

Cited by 53 publications

References 13 publications

A gastrointestinal simulation system for dissolution of oral solid dosage forms before and after Roux-en-Y gastric bypass

A gastrointestinal simulation system for dissolution of oral solid dosage forms before and after Roux-en-Y gastric bypass

Gastroesophageal reflux disease in the obese: Pathophysiology and treatment

Perioperative management of the severely obese patient: a selective pathophysiological review

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