Document Detail


Postprandial antropyloroduodenal motility and gastric emptying in gastroparesis--effects of cisapride.
MedLine Citation:
PMID:  8307466     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There is little information about the organisation of antroduodenal contractions or pyloric motility in patients with gastroparesis. The mechanisms responsible for the acceleration of gastric emptying by cisapride in patients with gastroparesis are also poorly understood. Simultaneous manometric and scintigraphic recordings were performed in 12 patients with gastroparesis and nine healthy volunteers before and after cisapride administration. Antropyloroduodenal pressures were recorded with a sleeve/side hole manometric assembly and gastric emptying with a scintigraphic method. Thirty minutes after the solid component of the test meal had begun to empty from the stomach all subjects received 5 mg cisapride intravenously over 10 minutes and recordings continued for a further 60 minutes. In the 30 minutes before cisapride there was no significant difference in the number of antral pressure waves (median 20 v 33, NS), basal pyloric pressure, or the number of isolated pyloric pressure waves between patients and volunteers, but the number of antral waves of extent > or = 6 cm (median 1 v 5, p < 0.05) was less in the patients, as was gastric emptying (8% v 20%, p < 0.05). In the patients, there was no change in the number of antral waves after cisapride, but there was an increase in the number of antral waves > or = 6 cm in extent (median 7 v 1, p < 0.05) and in the rate of gastric emptying (26% v 8%, p < 0.01). In the healthy subjects, cisapride increased gastric emptying (31% v 20%, p < 0.05), but reduced the number of antral waves (10 v 33, p < 0.05). Cisapride had no significant effect on the number of antral waves of extent more than or equal to 6 cm (11 v 5, NS). The number of isolated pyloric pressure waves decreased after cisapride (4 v 11, p < 0.05). There was a relationship between gastric emptying and the number of antral pressure waves of extent more than or equal to 6 cm in both the patients (r=0.38, p<0.05) and healthy subjects (r=0.05, p<0.01). There was no significant relationship between gastric emptying and the number of antral waves. It is concluded that disturbance of the relationship between antral, pyloric, and duodenal pressure waves is a major abnormality of postprandial gastric motor function in patients with gastroparesis. The stimulation of antral pressure waves of extent more than or equal to 6 cm may contribute to the acceleration of gastric emptying produced by cisapride in patients with gastroparesis and in normal subjects.
Authors:
R J Fraser; M Horowitz; A F Maddox; J Dent
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gut     Volume:  35     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-03-15     Completed Date:  1994-03-15     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  172-8     Citation Subset:  AIM; IM    
Affiliation:
Gastroenterology Unit, Royal Adelaide Hospital, South Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cisapride
Clinical Protocols
Duodenum / physiopathology
Female
Gastric Emptying / drug effects,  physiology*
Gastrointestinal Motility / drug effects,  physiology*
Humans
Male
Manometry
Middle Aged
Piperidines / therapeutic use*
Pyloric Antrum / physiopathology
Serotonin Antagonists / therapeutic use*
Stomach Diseases / drug therapy,  physiopathology*
Chemical
Reg. No./Substance:
0/Piperidines; 0/Serotonin Antagonists; 81098-60-4/Cisapride
Comments/Corrections
Comment In:
Gut. 1995 May;36(5):798-9   [PMID:  7797136 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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