Skip to main content
Gut logoLink to Gut
. 1994 Mar;35(3):333–337. doi: 10.1136/gut.35.3.333

Pharmacological modulation of gastric emptying rate of solids as measured by the carbon labelled octanoic acid breath test: influence of erythromycin and propantheline.

B D Maes 1, M I Hiele 1, B J Geypens 1, P J Rutgeerts 1, Y F Ghoos 1, G Vantrappen 1
PMCID: PMC1374585  PMID: 8150342

Abstract

The *C (13C or 14C) labelled octanoic acid breath test was recently developed to measure the gastric emptying rate of solids. This study aimed to investigate whether it is sensitive enough to detect pharmacologically induced changes in the gastric emptying rate. Nine healthy volunteers were studied in basal condition, after intravenous administration of 200 mg erythromycin, and after peroral administration of 30 mg propantheline. Erythromycin significantly enhanced gastric emptying in all subjects, with an increase of the gastric emptying coefficient (p = 0.0043) in eight of nine and a fall in both the gastric half emptying time (p = 0.0020) and the lag phase (p = 0.0044) in all nine. Propantheline significantly reduced the gastric emptying rate, with a decreased gastric emptying coefficient (p = 0.0007) and an increased gastric half emptying time (p = 0.0168) in all subjects, but no change in the lag phase (p = 0.1214). Further mathematical analysis showed that breath sampling at 15 minutes intervals over a four hour period is recommended to guarantee accuracy and the discriminative value of the breath test in various gastric emptying patterns. In conclusion the *C labelled octanoic acid breath test is sufficiently sensitive to show pharmacologically induced changes of gastric emptying rates of solids.

Full text

PDF
333

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amidon G. L., DeBrincat G. A., Najib N. Effects of gravity on gastric emptying, intestinal transit, and drug absorption. J Clin Pharmacol. 1991 Oct;31(10):968–973. doi: 10.1002/j.1552-4604.1991.tb03658.x. [DOI] [PubMed] [Google Scholar]
  2. Bach A. C., Babayan V. K. Medium-chain triglycerides: an update. Am J Clin Nutr. 1982 Nov;36(5):950–962. doi: 10.1093/ajcn/36.5.950. [DOI] [PubMed] [Google Scholar]
  3. Brömster D., Carlberger G., Lundh G., Möller J., Rosén A. The effect of some oral anticholinergics on gastric emptying, pH and osmolarity in man. Scand J Gastroenterol. 1969;4(2):185–192. doi: 10.3109/00365526909179927. [DOI] [PubMed] [Google Scholar]
  4. Chaudhuri T. K., Fink S. Update: pharmaceuticals and gastric emptying. Am J Gastroenterol. 1990 Mar;85(3):223–230. [PubMed] [Google Scholar]
  5. Ghoos Y. F., Maes B. D., Geypens B. J., Mys G., Hiele M. I., Rutgeerts P. J., Vantrappen G. Measurement of gastric emptying rate of solids by means of a carbon-labeled octanoic acid breath test. Gastroenterology. 1993 Jun;104(6):1640–1647. doi: 10.1016/0016-5085(93)90640-x. [DOI] [PubMed] [Google Scholar]
  6. Haycock G. B., Schwartz G. J., Wisotsky D. H. Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr. 1978 Jul;93(1):62–66. doi: 10.1016/s0022-3476(78)80601-5. [DOI] [PubMed] [Google Scholar]
  7. Hurwitz A., Robinson R. G., Herrin W. F. Prolongation of gastric emptying by oral propantheline. Clin Pharmacol Ther. 1977 Aug;22(2):206–210. doi: 10.1002/cpt1977222206. [DOI] [PubMed] [Google Scholar]
  8. Hurwitz A., Robinson R. G., Vats T. S., Whittier F. C., Herrin W. F. Effects of antacids on gastric emptying. Gastroenterology. 1976 Aug;71(2):268–273. [PubMed] [Google Scholar]
  9. Janssens J., Peeters T. L., Vantrappen G., Tack J., Urbain J. L., De Roo M., Muls E., Bouillon R. Improvement of gastric emptying in diabetic gastroparesis by erythromycin. Preliminary studies. N Engl J Med. 1990 Apr 12;322(15):1028–1031. doi: 10.1056/NEJM199004123221502. [DOI] [PubMed] [Google Scholar]
  10. Jian R., Ducrot F., Piedeloup C., Mary J. Y., Najean Y., Bernier J. J. Measurement of gastric emptying in dyspeptic patients: effect of a new gastrokinetic agent (cisapride). Gut. 1985 Apr;26(4):352–358. doi: 10.1136/gut.26.4.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. McGarry J. D., Foster D. W. Regulation of hepatic fatty acid oxidation and ketone body production. Annu Rev Biochem. 1980;49:395–420. doi: 10.1146/annurev.bi.49.070180.002143. [DOI] [PubMed] [Google Scholar]
  12. Minami H., McCallum R. W. The physiology and pathophysiology of gastric emptying in humans. Gastroenterology. 1984 Jun;86(6):1592–1610. [PubMed] [Google Scholar]
  13. Nimmo J., Heading R. C., Tothill P., Prescott L. F. Pharmacological modification of gastric emptying: effects of propantheline and metoclopromide on paracetamol absorption. Br Med J. 1973 Mar 10;1(5853):587–589. doi: 10.1136/bmj.1.5853.587. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Nimmo W. S., Heading R. C., Wilson J., Tothill P., Prescott L. F. Inhibition of gastric emptying and drug absorption by narcotic analgesics. Br J Clin Pharmacol. 1975 Dec;2(6):509–513. doi: 10.1111/j.1365-2125.1975.tb00568.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Nowak A., Jonderko K., Kaczor R., Nowak S., Skrzypek D. Cigarette smoking delays gastric emptying of a radiolabelled solid food in healthy smokers. Scand J Gastroenterol. 1987 Jan;22(1):54–58. doi: 10.3109/00365528708991856. [DOI] [PubMed] [Google Scholar]
  16. Peeters T., Matthijs G., Depoortere I., Cachet T., Hoogmartens J., Vantrappen G. Erythromycin is a motilin receptor agonist. Am J Physiol. 1989 Sep;257(3 Pt 1):G470–G474. doi: 10.1152/ajpgi.1989.257.3.G470. [DOI] [PubMed] [Google Scholar]
  17. Ramsbottom N., Hunt J. N. Effect of exercise on gastric emptying and gastric secretion. Digestion. 1974;10(1):1–8. doi: 10.1159/000197517. [DOI] [PubMed] [Google Scholar]
  18. Read N. W., Al Janabi M. N., Bates T. E., Barber D. C. Effect of gastrointestinal intubation on the passage of a solid meal through the stomach and small intestine in humans. Gastroenterology. 1983 Jun;84(6):1568–1572. [PubMed] [Google Scholar]
  19. Roland J., Dobbeleir A., Vandevivere J., Ham H. R. Effect of mild mental stress on solid phase gastric emptying in healthy subjects. Nucl Med Commun. 1990 Apr;11(4):319–326. doi: 10.1097/00006231-199004000-00011. [DOI] [PubMed] [Google Scholar]
  20. Thompson D. G., Richelson E., Malagelada J. R. Perturbation of upper gastrointestinal function by cold stress. Gut. 1983 Apr;24(4):277–283. doi: 10.1136/gut.24.4.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Tomomasa T., Kuroume T., Arai H., Wakabayashi K., Itoh Z. Erythromycin induces migrating motor complex in human gastrointestinal tract. Dig Dis Sci. 1986 Feb;31(2):157–161. doi: 10.1007/BF01300701. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES