The Effect of Erythromycin on Human Esophageal Motility Is Mediated by Serotonin Receptors

Koutsoumbi, Paraskevi; Epanomeritakis, E; Tsiaoussis, John; Athanasakis, Helias; Chrysos, Emmanuel; Zoras, Odysseas; Vassilakis, John Sophocles; Xynos, Evaghelos

doi:10.1111/j.1572-0241.2000.03278.x

Cited by 40 publications

(27 citation statements)

References 18 publications

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“…50,51 Several prokinetic drugs have shown an increase in amplitude of primary and secondary peristaltic oesophageal contractions, probably because of indirect cholinergic stimulation. 11,12,14,52 More recently, excitation of the afferent pathway by stimulating capsaicin receptors improved the motor performance of the oesophageal body in patients with IOM. 53 In the process of developing treatment strategies in GERD, testing the potential reversibility of IOM in patients with oesophagitis could be useful to predict the response of these patients to new prokinetic drugs.…”

Section: Discussionmentioning

confidence: 99%

“…There was no significant difference in prevalence of hiatal hernia among GERD patients without IOM (71%), mild IOM (61%) and severe IOM (59%). Patients with hiatal hernia had higher number of supine reflux events [18 (11-27) vs. 11 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21); P = 0.004] and oesophageal acid exposure [8.3% (3.4-16.1%) vs. 5% (1.4-13.4%); P = 0.020] compared with patients without hiatal her- nia. The LOS pressure was similar in patients with GERD without IOM [10 mmHg (7-13 mmHg)] and patients with mild IOM [9 mmHg (5-12.5 mmHg)].…”

Section: Relationship Between Severity Of Iom Presence Of Hiatal Hermentioning

confidence: 99%

“…Cisapride, bethanechol, metoclopramide, domperidone, erythromycin, sumatriptan, mosapride and itopride have been shown to enhance oesophageal motility in healthy subjects, but their effect in GERD patients is controversial being either marginal or absent. [11][12][13][14][15][16] Most studies showed a mild increase in amplitude of oesophageal contractions in oesophagitis patients as a group, but they failed to demonstrate individual conversion of patients from severe IOM into mild IOM or normal peristalsis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Relevance of mild ineffective oesophageal motility (IOM) and potential pharmacological reversibility of severe IOM in patients with gastro‐oesophageal reflux disease

Fornari

Blondeau

Durand

et al. 2007

Aliment Pharmacol Ther

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Section: Discussionmentioning

confidence: 99%

Section: Relationship Between Severity Of Iom Presence Of Hiatal Hermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relevance of mild ineffective oesophageal motility (IOM) and potential pharmacological reversibility of severe IOM in patients with gastro‐oesophageal reflux disease

Fornari

Blondeau

Durand

et al. 2007

Aliment Pharmacol Ther

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“…Erythromycin acts by stimulating motilin receptors in the upper gastrointestinal tract 55. 5HT3 receptors may also be involved in this process 63. There are no data for its use in palliative care, but it has been shown to be effective in diabetic gastroparesis 64.…”

Section: Drugs For Treating Nausea and Vomitingmentioning

confidence: 99%

Treating nausea and vomiting in palliative care: a review

Glare¹,

Miller²,

Nikolova³

et al. 2011

CIA

128

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Nausea and vomiting are portrayed in the specialist palliative care literature as common and distressing symptoms affecting the majority of patients with advanced cancer and other life-limiting illnesses. However, recent surveys indicate that these symptoms may be less common and bothersome than has previously been reported. The standard palliative care approach to the assessment and treatment of nausea and vomiting is based on determining the cause and then relating this back to the “emetic pathway” before prescribing drugs such as dopamine antagonists, antihistamines, and anticholinergic agents which block neurotransmitters at different sites along the pathway. However, the evidence base for the effectiveness of this approach is meager, and may be in part because relevance of the neuropharmacology of the emetic pathway to palliative care patients is limited. Many palliative care patients are over the age of 65 years, making these agents difficult to use. Greater awareness of drug interactions and QTc prolongation are emerging concerns for all age groups. The selective serotonin receptor antagonists are the safest antiemetics, but are not used first-line in many countries because there is very little scientific rationale or clinical evidence to support their use outside the licensed indications. Cannabinoids may have an increasing role. Advances in interventional gastroenterology are increasing the options for nonpharmacological management. Despite these emerging issues, the approach to nausea and vomiting developed within palliative medicine over the past 40 years remains relevant. It advocates careful clinical evaluation of the symptom and the person suffering it, and an understanding of the clinical pharmacology of medicines that are available for palliating them.

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“…showed that the gastric phase III‐like migrating contractions, induced by an erythromycin derivative (EM574) in dogs, were the result of the stimulation of vagal cholinergic neurones, where 5‐HT 3 receptors are also involved 22 . In addition, we have recently shown that, in addition to cholinergic pathways, serotonin receptors are involved in the prokinetic effect of erythromycin on oesophageal motility in humans 23 . Based on the aforementioned observations, the first aim of this study was to test the hypothesis that 5‐HT 3 receptors are involved in the acceleration of gastric emptying after erythromycin administration in humans.…”

Section: Introductionmentioning

confidence: 99%

Octreotide enhances the accelerating effect of erythromycin on gastric emptying in healthy subjects

Athanasakis

Chrysos

Zoras

et al. 2002

Aliment Pharmacol Ther

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SUMMARYBackground: Erythromycin exhibits gastrokinetic properties through cholinergic pathways. Reports regarding the action of octreotide on gastric emptying are conflicting. Aim: To assess: (i) the hypothesis that serotonin receptors are involved in the accelerating effect of erythromycin on gastric emptying; and (ii) any modification of the gastrokinetic action of erythromycin induced by octreotide. Subjects and methods: Gastric emptying of a standard meal was estimated in 20 healthy subjects by scintigraphy on three different occasions in a double-blind, placebo-controlled manner and in random order: (i) after placebo; (ii) after 200 mg of intravenous erythromycin; and (iii) after 200 mg of intravenous

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The Effect of Erythromycin on Human Esophageal Motility Is Mediated by Serotonin Receptors

Cited by 40 publications

References 18 publications

Relevance of mild ineffective oesophageal motility (IOM) and potential pharmacological reversibility of severe IOM in patients with gastro‐oesophageal reflux disease

Relevance of mild ineffective oesophageal motility (IOM) and potential pharmacological reversibility of severe IOM in patients with gastro‐oesophageal reflux disease

Treating nausea and vomiting in palliative care: a review

Octreotide enhances the accelerating effect of erythromycin on gastric emptying in healthy subjects

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