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. 1998 Feb;42(2):243–250. doi: 10.1136/gut.42.2.243

Effect of gastric acid suppressants on human gastric motility

H Parkman 1, J Urbain 1, L Knight 1, K Brown 1, D Trate 1, M Miller 1, A Maurer 1, R Fisher 1
PMCID: PMC1726985  PMID: 9536950

Abstract

Background—The effect of histamine H2 receptor antagonists on gastric emptying is controversial. 
Aims—To determine the effects of ranitidine, famotidine, and omeprazole on gastric motility and emptying. 
Patients and methods—Fifteen normal subjects underwent simultaneous antroduodenal manometry, electrogastrography (EGG), and gastric emptying with dynamic antral scintigraphy (DAS). After 30 minutes of fasting manometry and EGG recording, subjects received either intravenous saline, ranitidine, or famotidine, followed by another 30 minutes recording and then three hours of postprandial recording after ingestion of a radiolabelled meal. Images were obtained every 10-15 minutes for three hours to measure gastric emptying and assess antral contractility. Similar testing was performed after omeprazole 20 mg daily for one week. 
Results—Fasting antral phase III migrating motor complexes (MMCs) were more common after ranitidine (9/15 subjects, 60%), famotidine (12/15, 80%), and omeprazole (8/12, 67%) compared with placebo (4/14, 29%; p<0.05). Postprandially, ranitidine, famotidine, and omeprazole slowed gastric emptying, increased the amplitude of DAS contractions, increased the EGG power, and increased the antral manometric motility index. 
Conclusions—Suppression of gastric acid secretion with therapeutic doses of gastric acid suppressants is associated with delayed gastric emptying but increased antral motility. 



Keywords: gastric motility; gastric emptying; histamine H2 receptor antagonists; proton pump inhibitors; gastric acid secretion; scintigraphy

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Figure 1 .

Figure 1

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Fasting antroduodenal manometry and EGG recording. This tracing, taken during the fasting pattern, depicts a phase III MMC starting in the antrum and progressing distally into the duodenum. 


Figure 2 .

Figure 2

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Postprandial antroduodenal manometry and EGG recording. In this tracing, prominent three cycle per minute antral contractile activity and three cycle per minute EGG activity are shown. 


Figure 3 .

Figure 3

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Effects of gastric acid suppressants on postprandial antral motility indexes. 


Figure 4 .

Figure 4

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Effects of gastric acid suppressants on gastric emptying. (A) Total gastric emptying; (B) proximal gastric emptying; (C) distal gastric emptying. 


Figure 5 .

Figure 5

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Dynamic antral scintigraphy. The time activity curve (A) depicts radioactive counts in the mid-antral region versus time for the placebo arm for a subject 60 minutes after meal ingestion. The phasic counts represent the contracting antrum. (B) represents the same subject at the same time period after omeprazole therapy. There were increased phasic excursions of the radioactive counts in the omeprazole period as compared with placebo. With the fast Fourier transform analysis, the dominant frequency is represented by the peak with the highest amplitude (C and D).


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