Intravenous Fat Emulsion (Intralipid) Delays Gastric Emptying, but Does Not Cause Gastroesophageal Reflux in Healthy Volunteers

Abstract

The impact of overnight intravenous lipid emulsion (ILE) infusion on upper gastrointestinal tract physiology was assessed in 10 healthy volunteers. No changes in lower esophageal sphincter pressure (before infusion: 28 +/- 4 mm Hg; after infusion 20.5 +/- 3; p:NS), plasma concentrations of gastrointestinal hormones (gastrin: preprandial before/after lipids: 14 +/- 2.1/13 +/- 1.4 pM; postprandial before/after lipids: 28 +/- 2.7/30 +/- 3.4 pM, CCK: preprandial before/after lipids: 69 +/- 10/64 +/- 10 pM; postprandial before/after lipids: 96 +/- 11/95 +/- 12 pM; neurotensin: levels less than 6 pM in all samples; somatostatin levels undetectable in all samples) nor on pathologic gastroesophageal reflux episodes (% of time of pH less than 4, before/after lipids: 0.6 +/- 0.4/0.15 +/- 0.09), were found (p = NS). In contrast, technetium gastric emptying studies showed a significant delay when comparing pre- and post-lipid infusion values (37 +/- 4/54 +/- 4%) (p greater than 0.005). The mechanism of this effect remains unexplained.

The Effect of Administered Dose of Lipid-Based Formulations on the In Vitro and In Vivo Performance of Cinnarizine as a Model Poorly Water-Soluble Drug

“…The current data suggest that increasing the quantity of co‐administered lipid (relative to drug) has the capacity to enhance oral bioavailability to a certain point, but that increases beyond 250 mg (∼750 mg/kg) provide little practical benefit and serve only to extend T max . The latter may reflect a reduction in gastric emptying due to the presence of higher quantities of lipid43,44 or a reduction in the efficiency of lipid digestion and processing.…”

Motility of the gastrointestinal tract and gallbladder during long‐term total parenteral nutrition in dogs

“…Casaubon et al 16 reported that IV lipid infusion caused gastric emptying delay, but they did not study the effect on the interdigestive motor activities in the stomach. Guedon et al 17 demonstrated that IV lipid infusion with a high infusion rate (5 hours of 100 mL/h infusion) decreased occurrences of phase III in the jejunum.…”

American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis

“…La administración intravenosa de emulsiones de grasa también retrasa el vaciamiento gástrico y puede contribuir a este fenómeno. 149,150 Trastornos de la alimentación. La anorexia nerviosa es una afección psiquiátrica que ocurre principalmente en mujeres adolescentes y adultas jóvenes caracterizado por una deformación de la imagen corporal y temor a la obesidad con dietas compulsivas e inanición autoimpuesta para conservar un peso corporal notablemente bajo.…”