Effect of gastric acid suppressants on human gastric motility

Abstract

Background-The eVect of histamine H 2 receptor antagonists on gastric emptying is controversial. Aims-To determine the eVects 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. (Gut 1998;42:243-250)

Omeprazole delays gastric emptying in healthy volunteers: an effect prevented by tegaserod

“…1 While considered generally safe, omeprazole in daily doses of 20-40 mg has been shown to significantly delay gastric emptying. [2][3][4][5] The magnitude of the delay in gastric emptying produced by omeprazole ranges from 15% to as much as 40%. 2,3 Delayed gastric emptying has been associated with adverse effects including development of dyspeptic symptoms [6][7][8] and proximal gastrointestinal (GI) tract bacterial overgrowth.…”

“…[2][3][4][5] The magnitude of the delay in gastric emptying produced by omeprazole ranges from 15% to as much as 40%. 2,3 Delayed gastric emptying has been associated with adverse effects including development of dyspeptic symptoms [6][7][8] and proximal gastrointestinal (GI) tract bacterial overgrowth. 9,10 A variable but substantial proportion of patients with symptomatic GERD who are candidates for treatment with a PPI already have delayed gastric emptying.…”

Refluxo gastroesofágico em cães anestesiados: fisiopatologia, clínica, diagnóstico e terapêutica

“…Além disso, doses terapêuticas de ranitidina aumentam as contrações do antro gástrico, devido à inibição da acetilcolinesterase, efeito agonista colinérgico direto ou aumento da liberação neuronal de acetilcolina, o que lhes confere o efeito procinético com capacidade de aumentar o tônus do EEG (PARKMAN et al, 1998).…”

Duodenal hypersensitivity to acid in patients with functional dyspepsia-pathogenesis and evaluation

“…Lowering of the duodenal pH prevents the occurrence of the gastric phase III (Woodtli et al, 1995), and, in animals, duodenal acidification induces gastric relaxation by exerting an inhibitory effect on the stomach (Lu et al, 1999). Duodenal acidification has an inhibitory effect on gastric emptying (Danzer et al, 2004;Raybould et al, 1993;Cooke, 1974;Mearadji et al, 1999;Parkman et al, 1998), and hydrochloric acid (HCl) may restrict gastric outflow by inducing tonic occlusion of the duodenum (Parkman et al, 1998).…”