The Effect of Exenatide and Erythromycin on Postprandial Symptoms and Their Relation to Gastric Functions

Yoon, Seung Bae; Choi, Myung‐Gyu; Lim, Chul-Hyun; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Kyu Yong; Chung, In‐Sik

doi:10.1159/000335933

Cited by 7 publications

(4 citation statements)

References 62 publications

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“…This hypothesis was supported by our previous study, which showed significant negative linear correlation between the postprandial gastric volume change measured by SPECT and the total aggregate symptom score of NDT in healthy volunteers. 22 This correlation was also observed even after exenatide. Tack et al also demonstrated that maximal tolerated volume measured by slow nutrient drink correlated with meal induced accommodation determined by gastric barostat.…”

Section: Discussionmentioning

confidence: 68%

“…Our previous study showed that this nutrient drink test protocol demonstrated the effects of erythromycin and exenatide, which modify gastric motility, fairly well. 22 A recent trial of amitriptyline for FD used maximal satiety as an outcome parameter when drinking 100 mL of a nutrient drink at every minute. 16 However, amitriptyline did not affect the subjects' drinking capacity or the postprandial symptoms evoked by the drink test, although the total clinical symptom score and nausea were reduced after treatment.…”

Section: Discussionmentioning

confidence: 99%

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Applying Novel Nutrient Drink to Clinical Trial of Functional Dyspepsia

Lim¹,

Choi²,

Baeg³

et al. 2014

J Neurogastroenterol Motil

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Background/AimsThe drink test has been regarded as a surrogate marker of gastric accommodation. The aims of this study were to develop a novel nutrient drink test (NDT) protocol and investigate its potential for application to a clinical trial of functional dyspepsia (FD). MethodsA novel NDT was designed, involving drinking 125 mL of nutrient 4 times at 5-minute intervals or until maximal tolerability. Healthy volunteers and patients with FD rated their symptoms every 5 minutes for 20 minutes in a developmental study. Patients with FD were enrolled in an open trial of itopride for 4 weeks. NDT was performed before and after treatment. Improvement of integrative symptoms score during NDT after treatment for more than 50% compared with baseline was defined as responder. ResultsTotal aggregate symptom scores, sum of symptom scores measured during NDT, were higher in FD patients (n = 40, 368.1 ± 245.3) than in controls (n = 19, 215.9 ± 171.2) (P = 0.018) in a developmental study. In an open trial of itopride, symptom scores measured during NDT decreased significantly at all time points after treatment in responders (n = 49), whereas did not in non-responders (n = 25). Total aggregate symptom score for NDT correlated significantly with integrative dyspeptic symptom score, sum of 8 symptom scores of NDI questionnaire, at baseline (r = 0.374, P = 0.001) and after treatment (r = 0.480, P ＜ 0.001). ConclusionsOur novel NDT can quantify dyspeptic symptoms and reflected therapeutic effects of itopride treatment in a clinical trial of FD patients. This NDT can be used as an effective parameter in clinical trials or drug development programs for assessing effects of novel therapies on postprandial symptoms.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Applying Novel Nutrient Drink to Clinical Trial of Functional Dyspepsia

Lim¹,

Choi²,

Baeg³

et al. 2014

J Neurogastroenterol Motil

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“…Regarding prokinetic agents, domperidone [73] and erythromycin [83] seem to induce a normal gastric myoelectrical activity together with an improvement in upper gastrointestinal symptoms and emptying time. However, their ameliorating effects on symptoms of dyspepsia are often limited.…”

Section: Validation Of Eggmentioning

confidence: 99%

Electrogastrography in Adults and Children: The Strength, Pitfalls, and Clinical Significance of the Cutaneous Recording of the Gastric Electrical Activity

Riezzo

Russo

Indrio

2013

BioMed Research International

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Cutaneous electrogastrography (EGG) is a non-invasive technique to record gastric myoelectrical activity from the abdominal surface. Although the recent rapid increase in the development of electrocardiography, EGG still suffers from several limitations. Currently, computer analysis of EGG provides few reliable parameters, such as frequency and the percentage of normal and altered slow wave activity (bradygastria and tachygastria). New EGG hardware and software, along with an appropriate arrangement of abdominal electrodes, could detect the coupling of the gastric slow wave from the EGG. At present, EGG does not diagnose a specific disease, but it puts in evidence stomach motor dysfunctions in different pathological conditions as gastroparesis and functional dyspepsia. Despite the current pitfalls of EGG, a multitasking diagnostic protocol could involve the EGG and the 13C-breath testing for the evaluation of the gastric emptying time—along with validated gastrointestinal questionnaires and biochemical evaluations of the main gastrointestinal peptides—to identify dyspeptic subgroups. The present review tries to report the state of the art about the pathophysiological background of the gastric electrical activity, the recording and processing methodology of the EGG with particular attention to multichannel recording, and the possible clinical application of the EGG in adult and children.

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“…This negative result may be explained by the non-physiological effects of motilin analogues in the postprandial state, since motilin is a typical interdigestive hormone that activates phase III-like activity with a gastric component, thus emptying large undigested particles, unprepared to undergo digestion in the proximal small bowel. Since some patients with gastroparesis also present with impaired gastric accommodation, erythromycin should not be prescribed, as it increases fundic tone 121. The increase in fundic tone may have also contributed to the negative study result of the motilin-like agent.…”

Section: Introductionmentioning

confidence: 99%

Gastroparesis: a turning point in understanding and treatment

Grover

Farrugia

Stanghellini

2019

Gut

184

219

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Gastroparesis is defined by delayed gastric emptying (GE) and symptoms of nausea, vomiting, bloating, postprandial fullness, early satiety and abdominal pain. Most common aetiologies include diabetes, postsurgical and postinfectious, but in many cases it is idiopathic. Clinical presentation and natural history vary by the aetiology. There is significant morbidity and healthcare utilisation associated with gastroparesis. Mechanistic studies from diabetic animal models of delayed GE as well as human full-thickness biopsies have significantly advanced our understanding of this disorder. An innate immune dysregulation and injury to the interstitial cells of Cajal and other components of the enteric nervous system through paracrine and oxidative stress mediators is likely central to the pathogenesis of gastroparesis. Scintigraphy and 13C breath testing provide the most validated assessment of GE. The stagnant gastroparesis therapeutic landscape is likely to soon see significant changes. Relatively newer treatment strategies include antiemetics (aprepitant), prokinetics (prucalopride, relamorelin) and fundic relaxants (acotiamide, buspirone). Endoscopic pyloromyotomy appears promising over the short term, especially for symptoms of nausea and vomiting. Further controlled trials and identification of the appropriate subgroup with pyloric dysfunction and assessment of long-term outcomes are essential. This review highlights the clinical presentation, diagnosis, mechanisms and treatment advancements for gastroparesis.

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The Effect of Exenatide and Erythromycin on Postprandial Symptoms and Their Relation to Gastric Functions

Cited by 7 publications

References 62 publications

Applying Novel Nutrient Drink to Clinical Trial of Functional Dyspepsia

Applying Novel Nutrient Drink to Clinical Trial of Functional Dyspepsia

Electrogastrography in Adults and Children: The Strength, Pitfalls, and Clinical Significance of the Cutaneous Recording of the Gastric Electrical Activity

Gastroparesis: a turning point in understanding and treatment

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