Human postprandial gastric emptying of 1–3-millimeter spheres

Meyer, James H.; Elashoff, Janet D.; Porter-Fink, Vicki; Dressman, Jennifer B.; Amidon, Gordon L.

doi:10.1016/0016-5085(88)90669-5

Cited by 224 publications

(103 citation statements)

References 13 publications

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“…It has been assumed that radio-opaque markers act as indigestible solids, and are cleared from the stomach by phase III of the interdigestive migrating motor complex (MMC). 13,14 Phase III of the MMC usually occurs, with a considerable interindividual variation, every 90±120 min in the fasting state and cleans from the stomach and small bowel indigestible solids, debris and microbes, 15,16 justifying the term`gastrointestinal housekeeper'. 17 Hence, the accelerating effect of cisapride on the clearance of radioopaque markers after 4 h could be explained by an earlier occurrence of a fasting state of the stomach followed by the initiation of a MMC, due to improved gastric emptying of digestible solids.…”

Section: Discussionmentioning

confidence: 99%

The effect of a single rectal dose of cisapride on delayed gastric emptying

Brummer

Schoenmakers

Kemerink

et al. 1997

Aliment Pharmacol Ther

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Background: Cisapride has an established prokinetic effect in patients with delayed gastric emptying. However, rectal administration of the drug might be preferred in patients with either dysphagia or nausea due to gastroparesis. Aim: To determine the effect of a single rectal dose of cisapride 60 mg on gastric emptying in patients with delayed gastric emptying. Methods: Thirty‐two patients (16 males, 16 females) with demonstrated delayed gastric emptying received a single dose of two suppositories containing either cisapride (2 × 30 mg) or placebo, according to a double‐blind randomized crossover design. Three hours after administration of the suppositories, the patients received a radio‐labelled test meal and radio‐opaque markers for measurement of gastric emptying. Results: The mean t½ after cisapride administration (76 min, 95% CI: 68–95) was significantly shorter (P = 0.005; n = 28, per‐protocol analysis) than after placebo administration (104 min, 81–126). Four hours after ingestion of the meal significantly fewer radio‐opaque markers remained in the stomach after cisapride than after placebo administration (P < 0.05). Mild to moderate adverse events, mainly involving the gastrointestinal tract, were reported in 10 patients (31%) after cisapride treatment and in four patients (13%) after placebo (N.S.; n = 32). Conclusion: A single suppository dose of cisapride 60 mg significantly accelerates gastric emptying of the solid phase of a meal and of radio‐opaque markers in patients with previously demonstrated delayed gastric emptying.

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Section: Discussionmentioning

confidence: 99%

The effect of a single rectal dose of cisapride on delayed gastric emptying

Brummer

Schoenmakers

Kemerink

et al. 1997

Aliment Pharmacol Ther

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“…Presumably the many differences in pharmacological characteristics may be relevant to their differing performance in practice, including their quantitative and qualitative enzyme content, 95 dissolution characteristics, 60 and size of the particles. 61,62 The individual differences in dose requirements, even in patients with little or no residual pancreatic function, are presumably due, in part, to these brand differences.…”

Section: Failure To Control Gastrointestinal Symptomsmentioning

confidence: 99%

Diagnosis and Treatment of Intestinal Malabsorption in Cystic Fibrosis

Littlewood

Wolfe

Conway

2005

Pediatric Pulmonology

100

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Summary. Intestinal malabsorption is severe and of early onset in virtually all people who have cystic fibrosis. The main cause is deficiency of pancreatic enzymes. Bicarbonate deficiency, abnormal bile salts, mucosal transport problems, motility differences, and anatomical structural changes are other contributory factors. Effective treatment should allow a normal to high-fat diet to be taken, control symptoms, correct malabsorption, and achieve a normal nutritional state and growth. Appropriate pancreatic enzyme replacement therapy will achieve normal or near-normal absorption in most people with cystic fibrosis. Early identification and treatment of intestinal malabsorption is critical to achieving optimal nutritional status. The occurrence of fibrosing colonopathy in a few patients on very high doses of those enzymes which have the copolymer Eudragit L30 D55 in their covering resulted in guidelines in the UK to avoid doses equivalent to more than 10,000 IU lipase per kg per day, and also to avoid preparations containing this copolymer in children and adolescents. For patients not responding to 10,000 IU lipase per kg per day review of adherence to treatment, change of enzyme preparation, variation in time of administration, and reduction in gastric acid may improve absorption. The importance of early investigation to exclude other gastrointestinal disorders as a cause of the patient's symptoms, rather than merely increasing the dose of enzymes, is stressed. With modern pancreatic enzymes in doses up to or only slightly in excess of 10,000 IU lipase per kg per day, adequate control of gastrointestinal symptoms and absorption can be achieved, and a normal nutritional state and growth rate maintained in most people with cystic fibrosis.

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“…Ohne begleitende Säuresuppression senken Präparate mit Säureschutz die Stuhlfettausscheidung stärker als solche ohne [352]. [353]. Allerdings kann eine geringe Partikelgröße auch nach distaler Magenresektion die Entleerung und/oder Freisetzung der Enzyme erleichtern und/oder beschleunigen.…”

Section: Leitlinie 1187unclassified