Slow gastric emptying induced by high fat content of meal accelerated by cisapride administered rectally

Abstract

The evaluation of agents potentially accelerating gastric emptying in gastric stasis syndromes is time-consuming. Since a previous study showed that emptying is slowed after antecedent fat ingestion and intravenous cisapride abolishes this effect, we investigated whether emptying delayed by fat incorporated into a meal is reversed by cisapride and thus could serve as a model for such evaluations. Twelve healthy males received, under double-blind conditions, 30 mg cisapride rectally or placebo, and 3 hr thereafter a semisolid meal of low (9.2 g) or high (37.9 g) fat content. The sequence of combinations placebo/low-fat meal, placebo/high-fat meal, and cisapride/high-fat meal was randomized. Gastric emptying and antral motility were recorded scintigraphically. After placebo/high-fat, emptying was significantly slower (P less than 0.05) than after placebo/low-fat. After cisapride/high-fat, emptying was significantly faster (P less than 0.01) than after placebo/high-fat and similar to that after placebo/low-fat. Antral motility was little affected. The slow emptying of a high-fat meal thus seems a suitable model for the evaluation of prokinetic drug effects.

Effects of cisapride on gastric emptying of oil and aqueous meal components, hunger, and fullness.

“…9 10 As a result of diminished small intestinal feedback, gastric emptying of oil is faster than normal in patients with pancreatic insufficiency. "1 Our finding that gastric emptying of oil was accelerated by cisapride is consistent with previous studies.2 3 Stacher et al reported that the retardation of gastric emptying of a semisolid meal by giving a fat preload to normal subjects was abolished by both intravenous2 and rectal3 administration of cisapride, while in dogs, Janisch et al (XI International symposium on gastrointestinal motility, 1987) found that gastric emptying of a barium meal containing 20 ml olive oil was also accelerated by cisapride. It should, however, be recognised that the magnitude of the increase in gastric emptying of oil induced by cisapride that we observe was small and reflected a reduction in the duration of the lag phase, with no significant change in the post-lag emptying rate.…”

Effects of lipase inhibition on gastric emptying and alcohol absorption in healthy subjects

“…If it is assumed that the cream emptied from the stomach at a rate of about 12·6 kJ/min (3 kcal/min) (Edelbroek et al 1993), some 25 % should have entered the small intestine at the time of ingestion of the drink. The presence of digested and digestible fat in the small intestine would be expected to slow gastric emptying of the drink (Stacher et al 1991). The observed relationships between both plasma alcohol and blood glucose responses with gastric emptying are consistent with previous reports (Nimmo, 1976;Holt, 1981;Horowitz et al 1993a;Jones et al 1996), which have established that the latter is evident even after low carbohydrate loads (O'Donovan et al 2004b;Chaikomin et al 2005).…”

“…Of the three macronutrients, fat is the most potent in slowing gastric emptying, primarily because of its higher energy density, and potentially also because its absorption rate is relatively slower (Lin et al 1996). Accordingly, consumption of fat before, or with, a meal slows gastric emptying (Cunningham & Read, 1989;Stacher et al 1990Stacher et al , 1991Davidson et al 1999), and delays the absorption of orally administered nutrients (Welch et al 1987;Cunningham & Read, 1989;Hebbard et al 1995). For example, when lipid is infused directly into the small intestine before the consumption of, or incorporated into, a carbohydrate-containing (potato) meal, the glycaemic response to that meal is substantially less (Welch et al 1987;Cunningham & Read, 1989).…”

Acute Exercise and Gastric Emptying: A Meta-Analysis and Implications for Appetite Control

“…In contrast to carbohydrate, protein and fat content were either not reported or did not vary between the majority of studies in the current analysis. Under resting conditions, GE is slower following a high-fat compared with a low-fat meal [108]. The influence of macronutrient composition on GE, in particular dietary fat with exercise, requires further investigation.…”