Effect of oral erythromycin on gallbladder motility in normal subjects and subjects with gallstones

Catnach, S.; Fairclough, Peter D.; Trembath, Richard; O'donnell, L. J. D.; McLean, Alison; Law, Penny A.; Wickham, J. E. A.

doi:10.1016/0016-5085(92)90334-u

Cited by 75 publications

(38 citation statements)

References 31 publications

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“…This prokinetic effect persists even after 1 month on the drug. 38 Because both erythromycin and motilin have little direct effect on gallbladder smooth muscle, [46][47][48] it is most likely that the enhanced gallbladder contractility measured here in vitro is secondary to a much-improved CSI. The reduction in cholesterol saturation should alleviate the smooth muscle defect, which results when excess cholesterol in bile absorbs into the gallbladder wall 10,49 and disrupts signalling across the membrane.…”

Section: Discussionmentioning

confidence: 94%

“…Oral erythromycin significantly reduces both fasting and postprandial gallbladder volumes in healthy subjects and in patients with cholesterol gallstones. 22,38 Erythromycin also reverses the gallbladder-emptying defect found in patients with cholesterol gallstones. This prokinetic effect persists even after 1 month on the drug.…”

Section: Discussionmentioning

confidence: 98%

“…The reduced fasting gallbladder volume was not only consistent with a diminished pool size, but also indicated the effectiveness of chronic erythromycin administration as a prokinetic agent. 38 Reducing 39-41 or eliminating 9,10 the residence time of bile salts in the gallbladder and/or accelerating small intestinal transit 8 promotes bile salt secretion, reduces the CSI, and might have a role in preventing stone formation both in humans and in animal models. 24,[39][40][41] Conceivably, erythromycin treatment might have decreased the absorption of cholesterol, perhaps through very rapid intestinal transit.…”

Section: Discussionmentioning

confidence: 99%

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Effect of the prokinetic agent, erythromycin, in the richardson ground squirrel model of cholesterol gallstone disease

Scott

Tan

et al. 1998

Hepatology

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of the prokinetic agent, erythromycin, in the richardson ground squirrel model of cholesterol gallstone disease

Scott

Tan

et al. 1998

Hepatology

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“…8 Reduction in gallbladder motility leading to prolonged stasis of bile in the gallbladder is one of the essential factors in the pathogenesis of cholelithiasis. 10,26 Pitt et al 38 showed experimentally that an increased resistance to flow (i.e. pressure drop) in the cystic duct, and not altered gallbladder compliance, is etiologically related to bile stasis.…”

Section: Introductionmentioning

confidence: 99%

Non-Newtonian Bile Flow in Elastic Cystic Duct: One- and Three-Dimensional Modeling

Luo

Chin

et al. 2008

Ann Biomed Eng

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Abstract-Bile flow is thought to play an essential role in the pathophysiological genesis of cholelithiasis (gallstone formation) and in gallbladder pain. In this paper, we extend our previous study of the human biliary system (Li et al., 2007, J. Biomech. Eng., 129:164-173) to include two important factors: the non-Newtonian properties of bile, and elastic deformation of the cystic duct. A one-dimensional (1D) model is analyzed and compared with three-dimensional (3D) fluid-structure interaction simulations. It is found that non-Newtonian bile raises resistance to the flow of bile, which can be augmented significantly by the elastic deformation (collapse) of the cystic duct. We also show that the 1D model predicts the pressure drop of the cystic duct flow well for all cases considered (Newtonian or non-Newtonian flow, rigid or elastic ducts), when compared with the full 3D simulations.

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“…In order to treat biliary stasis, a variety of drugs is under continued investigation. Induction of biliary motility has most extensively been studied with cholecystokinin, ceruletid and, more recent ly, erythromycin [11,12,14,15,18,[32][33][34][35], Cholecysto kinin (CKK) has been well characterized in animal mod els and several observational clinical trials have shown its effectiveness; however, it has never gained widespread clinical acceptance. Ceruletid is known to provoke gall bladder contraction and relaxation of the sphincter of Oddi in healthy subjects [11,12,18].…”

Section: Discussionmentioning

confidence: 99%

Influence of Ceruletid on Gallbladder Contraction: A Possible Prophylaxis of Acute Acalculous Cholecystitis in Intensive Care Patients?

Hasse¹,

Zielke²,

Nies³

et al. 1995

Digestion

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The purpose of this study was to investigate the utility of repeated applications of ceruletid to reduce gallbladder volume and its feasibility as a means of prophylaxis of acute acalculous cholecystitis in intensive care patients. First, a dose-response curve of ceruletid was obtained in 20 mechanically ventilated patients of a surgical intensive care unit (SICU) not receiving enteral nutrition. An effective dose of ceruletid, defined by a 50% reduction of gallbladder volume was established and subsequently studied in 40 mechanically ventilated SICU patients on total parenteral nutrition in a prospective, randomized, controlled, triple-blind trial. Gallbladder volume, sludge formation and side effects were evaluated. A dose of 1.5 μg/kg body weight ceruletid was established as the effective dose, causing 50% reduction of gallbladder volume in all patients studied and reduction of gallbladder sludge in 95%. In 67.5% of patients side effects were observed, requiring therapeutic intervention in 68%. It is concluded that ceruletid is effective in stimulating gallbladder contraction and reducing sludge formation in severely ill patients on intensive care units. Its routine use as prophylaxis of acute acalculous cholecystitis, however, may be limited by the nature, severity and frequency of side effects.

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Effect of oral erythromycin on gallbladder motility in normal subjects and subjects with gallstones

Cited by 75 publications

References 31 publications

Effect of the prokinetic agent, erythromycin, in the richardson ground squirrel model of cholesterol gallstone disease

Effect of the prokinetic agent, erythromycin, in the richardson ground squirrel model of cholesterol gallstone disease

Non-Newtonian Bile Flow in Elastic Cystic Duct: One- and Three-Dimensional Modeling

Influence of Ceruletid on Gallbladder Contraction: A Possible Prophylaxis of Acute Acalculous Cholecystitis in Intensive Care Patients?

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