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

Tougas, Gervais; Earnest, David L.; Chen, Y.; Vanderkoy, C.; Rojavin, Mikhail

doi:10.1111/j.1365-2036.2005.02528.x

Cited by 52 publications

(49 citation statements)

References 23 publications

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“…This inhibition of gastric emptying caused by rabeprazole is consistent with some previous studies using PPI (Benini et al 1996;Rasmussen et al 1997Rasmussen et al , 1999Parkman et al 1998;Anjiki et al 2005;Tougas et al 2005;Takahashi et al 2006), but at variance with others that failed to show any association between PPI administration and gastric emptying (Vidon et al 1993;Jones et al 2003;Grudell et al 2006). It has been supposed that such discrepancies may be partly explained by the use of different meal compositions and forms, and by the different methods for evaluating gastric emptying.…”

Section: Discussionsupporting

confidence: 87%

“…Although there have been conflicting reports on PPI and gastric emptying, significant studies reported delayed gastric emptying by PPI administration (Benini et al 1996;Rasmussen et al 1997Rasmussen et al , 1999Parkman et al 1998;Anjiki et al 2005;Tougas et al 2005;Takahashi et al 2006), while other studies failed to show any significant change in the gastric emptying by the treatment (Vidon et al 1993;Jones et al 2003;Grudell et al 2006). Since a sufficient amount of gastric acid is essential for the generation of luminal NO in the stomach originating from dietary nitrate (McKnight et al 1997;Iijima et al 2003), the effect of dietary nitrate on gastric emptying, if any, would be modified by co-administration of PPI.…”

mentioning

confidence: 99%

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Lack of Modulation of Gastric Emptying by Dietary Nitrate in Healthy Volunteers

Terai

Iijima

Asanuma

et al. 2009

Tohoku J. Exp. Med.

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

Lack of Modulation of Gastric Emptying by Dietary Nitrate in Healthy Volunteers

Terai

Iijima

Asanuma

et al. 2009

Tohoku J. Exp. Med.

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“…This observation highlights the unresolved question of whether the low-fat, EggBeaters meal is even the optimal solid meal substrate; indeed, significantly different emptying between the EggBeaters meal and a radiolabeled liver at 3 h was reported in the original report ''validating'' the EggBeaters meal [1]. GES also has utility in the evaluation of the motility effects of drugs, such as has been reported for studies utilizing the 2 % fat EggBeaters meal [7,8] and with the higher-calorie (296 kcal) and 32 % fat scrambled eggs meal [9,10].…”

mentioning

confidence: 75%

Novel and Validated Approaches for Gastric Emptying Scintigraphy in Patients with Suspected Gastroparesis

Camilleri

Shin

2013

Dig Dis Sci

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Controversy exists regarding the relation of upper gastrointestinal symptoms to gastroparesis, which centers on the reportedly weak correlation between symptoms and gastric emptying (GE) measurements. Appropriate management of patients with suspected gastroparesis thus requires the use of validated assessments of GE.GE scintigraphy (GES) using a low-fat EggBeaters (chicken egg white) meal (ConAgra Foods Inc., Omaha, NE, USA) [1] is regarded as the gold standard due to standardized procedures, methods, and well-established normal values. Although this meal has the advantage of good tolerability by the majority of symptomatic patients, there are potential drawbacks: a few patients may not tolerate any solid meal, or the low fat and caloric content may not be able to adequately stress the system, failing to identify impaired gastric motor function in a subset of individuals. Therefore, identification of an alternative, appropriate test meal may be important for clinical and research applications.In this issue, Sachdeva et al.[2] compared GE of the low-fat EggBeaters solid meal (255 kcal containing 2 % fat, 24 % protein, 72 % carbohydrate, and 2 % fiber) to an Ensure Plus (Abbott Laboratories, North Chicago, IL, USA) liquid meal (350 kcal containing 28 % fat, 15 % protein, 57 % carbohydrate, and no fiber) to identify a valid alternative for patients unable to consume the standard low-fat egg-white meal. On separate days, 20 healthy volunteers participated in a well-designed prospective study comparing GES with these two meals; simultaneously, the authors evaluated gastric contractility using a wireless motility capsule (WMC) during both assessments.The objectives were to demonstrate feasibility and to provide hypothesis-generating data (e.g., definition of coefficient of variation [COV; standard deviation/mean] to facilitate the design of future studies).The conclusion that GE of a liquid nutrient meal is similar to that of low-fat egg-white meal (of similar calorie content) is valid, at least in healthy subjects. Nevertheless, as acknowledged by the authors, their results will require replication in a larger cohort, and in subjects with suspected gastroparesis who might differ from a healthy population in terms of having differential GE of solid versus liquid meals. Jones et al. [3] previously reported a significant but weak (r = 0.42, p \ 0.01) correlation between GE of solids and nutrient-containing liquids among 86 patients with diabetes mellitus. In the study by Sachdeva et al. [2], the correlation between the GE T 1/2 of the two meals was similarly weak (r = 0.53) among healthy subjects, suggesting that there are significant intraindividual differences in the emptying of the two meals, and that less than 30 % of the variance is attributable to the same mechanisms for emptying of the two types of meals.It is also necessary to clarify the inter-individual COV with the EggBeaters and the liquid nutrient meal. Diagnostic interpretation of GE T 1/2 by GES in an individual patient requires robust definition of the i...

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“…In contrast, the option of long-term PPI therapy was associated with a significant body weight gain in the present study. Omeprazole and other PPIs delay gastric emptying [6][7][8][9] , which induces postprandial fullness, dyspeptic symptoms, gastrointestinal bacterial overgrowth, and subsequent weight loss [10,11] . Our results have clearly demonstrated that long-term PPI therapy contributed significantly to body weight changes in patients with GERD by relieving the adverse symptoms rather than altering the state of gastric emptying.…”

Section: Discussionmentioning

confidence: 99%

Long-term treatment with proton pump inhibitor is associated with undesired weight gain

Yoshikawa

Nagato²,

Yamasaki³

et al. 2009

WJG

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AIM:To examine the effects of long-term proton pump inhibitor (PPI) therapy on body weight (BW) and body mass index (BMI) in patients with gastroesophageal reflux disease (GERD). METHODS:The subjects were 52 patients with GERD and 58 sex-and age-matched healthy controls. GERD patients were treated with PPI for a mean of 2.2 years (range, 0.8-5.7 years), and also advised on lifestyle modifications (e.g. selective diet, weight management). BW, BMI and other parameters were measured at baseline and end of study. RESULTS:Twenty-four GERD patients were treated daily with 10 mg omeprazole, 12 with 20 mg omeprazole, 8 with 10 mg rabeprazole, 5 with 15 mg lansoprazole, and 3 patients with 30 mg lansoprazole. At baseline, there were no differences in BW and BMI between reflux patients and controls. Patients with GERD showed increases in BW (baseline: 56.4 ± 10.4 kg, end: 58.6 ± 10.8 kg, mean ± SD, P < 0.0001) and BMI (baseline:23.1 ± 3.1 kg/m 2 , end: 24.0 ± 3.1 kg/m 2 , P < 0.001), but no such changes were noted in the control group. Mean BW increased by 3.5 kg (6.2% of baseline) in 37 (71%) reflux patients but decreased in only 6 (12%) patients during treatment. CONCLUSION:Long-term PPI treatment was associated with BW gain in patients with GERD. Reflux patients receiving PPI should be encouraged to manage BW through lifestyle modifications.

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

Cited by 52 publications

References 23 publications

Lack of Modulation of Gastric Emptying by Dietary Nitrate in Healthy Volunteers

Lack of Modulation of Gastric Emptying by Dietary Nitrate in Healthy Volunteers

Novel and Validated Approaches for Gastric Emptying Scintigraphy in Patients with Suspected Gastroparesis

Long-term treatment with proton pump inhibitor is associated with undesired weight gain

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