The effect of acute oral erythromycin on gallbladder motility and on upper gastrointestinal symptoms in gastrectomized patients with and without gallstones

A randomized, placebo-controlled ultrasonographic study

P. Portincasa, D. F. Altomare, A. Moschetta, G. Baldassarre, A. Di Ciaula, N. G. Venneman, M. Rinaldi, G. Vendemiale, V. Memeo, G. P. VanBerge-Henegouwen, G. Palasciano

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: Gastrectomy might be a risk factor for cholelithiasis and gallbladder stasis might play a major role. We studied fasting and postprandial gallbladder motility with 600 mg oral erythromycin or placebo in gastrectomized patients (with and without gallstones) and controls. METHODS: Seventeen patients operated on for gastric cancer (subtotal gastrectomy: n = 10, total gastrectomy: n = 7) were compared with 20 sex- and body-size matched healthy controls. Subjects randomly received erythromycin or placebo 30 min before the ingestion of a standard 200 ml liquid test meal. Gallbladder volume was estimated by ultrasonography until 120 min after test meal. A visual analog scale monitored GI perception of appetite, satiety, nausea, abdominal fullness and epigastric pain. RESULTS: Gastrectomized patients had increased fasting gallbladder volume (35.9 ± 3.4 ml versus 21.0 ± 1.4 ml, p = 0.0005) with faster postmeal emptying (T/2 14.8 ± 1.1 min versus 23.5 ± 1.5 min, p = 0.00019) than controls. Six patients developed small and asymptomatic gallstones, which did not influence gallbladder motility. In these patients, fasting gallbladder volume increased with time after surgery (r = +0.82, p = 0.047). Perception of satiety, abdominal fullness, and epigastric pain after ingestion of the test meal were all significantly greater in patients than in controls. Erythromycin significantly enhanced gallbladder emptying during fasting (p = 0.001) and postprandially in both patients and controls (0.002<p <0.017) and significantly reduced postmeal satiety and epigastric discomfort in gastrectomized patients. CONCLUSIONS: Increased fasting volume might be a form of stasis, predisposing patients to gallstone formation. Erythromycin improves fasting and postprandial gallbladder emptying and decreases upper GI symptoms in gastrectomized patients. (C) 2000 by Am. Coll. of Gastroenterology.

Original languageEnglish
Pages (from-to)3444-3451
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume95
Issue number12
DOIs
Publication statusPublished - 2000

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Gallstones
Erythromycin
Gallbladder
Placebos
Fasting
Gastrectomy
Gallbladder Emptying
Meals
Eating
Pain
Cholelithiasis
Body Size
Appetite
Gastroenterology
Visual Analog Scale
Nausea
Stomach Neoplasms
Ultrasonography

ASJC Scopus subject areas

  • Gastroenterology

Cite this

The effect of acute oral erythromycin on gallbladder motility and on upper gastrointestinal symptoms in gastrectomized patients with and without gallstones : A randomized, placebo-controlled ultrasonographic study. / Portincasa, P.; Altomare, D. F.; Moschetta, A.; Baldassarre, G.; Di Ciaula, A.; Venneman, N. G.; Rinaldi, M.; Vendemiale, G.; Memeo, V.; VanBerge-Henegouwen, G. P.; Palasciano, G.

In: American Journal of Gastroenterology, Vol. 95, No. 12, 2000, p. 3444-3451.

Research output: Contribution to journalArticle

Portincasa, P, Altomare, DF, Moschetta, A, Baldassarre, G, Di Ciaula, A, Venneman, NG, Rinaldi, M, Vendemiale, G, Memeo, V, VanBerge-Henegouwen, GP & Palasciano, G 2000, 'The effect of acute oral erythromycin on gallbladder motility and on upper gastrointestinal symptoms in gastrectomized patients with and without gallstones: A randomized, placebo-controlled ultrasonographic study', American Journal of Gastroenterology, vol. 95, no. 12, pp. 3444-3451. https://doi.org/10.1016/S0002-9270(00)02075-X
Portincasa, P. ; Altomare, D. F. ; Moschetta, A. ; Baldassarre, G. ; Di Ciaula, A. ; Venneman, N. G. ; Rinaldi, M. ; Vendemiale, G. ; Memeo, V. ; VanBerge-Henegouwen, G. P. ; Palasciano, G. / The effect of acute oral erythromycin on gallbladder motility and on upper gastrointestinal symptoms in gastrectomized patients with and without gallstones : A randomized, placebo-controlled ultrasonographic study. In: American Journal of Gastroenterology. 2000 ; Vol. 95, No. 12. pp. 3444-3451.
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abstract = "OBJECTIVE: Gastrectomy might be a risk factor for cholelithiasis and gallbladder stasis might play a major role. We studied fasting and postprandial gallbladder motility with 600 mg oral erythromycin or placebo in gastrectomized patients (with and without gallstones) and controls. METHODS: Seventeen patients operated on for gastric cancer (subtotal gastrectomy: n = 10, total gastrectomy: n = 7) were compared with 20 sex- and body-size matched healthy controls. Subjects randomly received erythromycin or placebo 30 min before the ingestion of a standard 200 ml liquid test meal. Gallbladder volume was estimated by ultrasonography until 120 min after test meal. A visual analog scale monitored GI perception of appetite, satiety, nausea, abdominal fullness and epigastric pain. RESULTS: Gastrectomized patients had increased fasting gallbladder volume (35.9 ± 3.4 ml versus 21.0 ± 1.4 ml, p = 0.0005) with faster postmeal emptying (T/2 14.8 ± 1.1 min versus 23.5 ± 1.5 min, p = 0.00019) than controls. Six patients developed small and asymptomatic gallstones, which did not influence gallbladder motility. In these patients, fasting gallbladder volume increased with time after surgery (r = +0.82, p = 0.047). Perception of satiety, abdominal fullness, and epigastric pain after ingestion of the test meal were all significantly greater in patients than in controls. Erythromycin significantly enhanced gallbladder emptying during fasting (p = 0.001) and postprandially in both patients and controls (0.002",
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T1 - The effect of acute oral erythromycin on gallbladder motility and on upper gastrointestinal symptoms in gastrectomized patients with and without gallstones

T2 - A randomized, placebo-controlled ultrasonographic study

AU - Portincasa, P.

AU - Altomare, D. F.

AU - Moschetta, A.

AU - Baldassarre, G.

AU - Di Ciaula, A.

AU - Venneman, N. G.

AU - Rinaldi, M.

AU - Vendemiale, G.

AU - Memeo, V.

AU - VanBerge-Henegouwen, G. P.

AU - Palasciano, G.

PY - 2000

Y1 - 2000

N2 - OBJECTIVE: Gastrectomy might be a risk factor for cholelithiasis and gallbladder stasis might play a major role. We studied fasting and postprandial gallbladder motility with 600 mg oral erythromycin or placebo in gastrectomized patients (with and without gallstones) and controls. METHODS: Seventeen patients operated on for gastric cancer (subtotal gastrectomy: n = 10, total gastrectomy: n = 7) were compared with 20 sex- and body-size matched healthy controls. Subjects randomly received erythromycin or placebo 30 min before the ingestion of a standard 200 ml liquid test meal. Gallbladder volume was estimated by ultrasonography until 120 min after test meal. A visual analog scale monitored GI perception of appetite, satiety, nausea, abdominal fullness and epigastric pain. RESULTS: Gastrectomized patients had increased fasting gallbladder volume (35.9 ± 3.4 ml versus 21.0 ± 1.4 ml, p = 0.0005) with faster postmeal emptying (T/2 14.8 ± 1.1 min versus 23.5 ± 1.5 min, p = 0.00019) than controls. Six patients developed small and asymptomatic gallstones, which did not influence gallbladder motility. In these patients, fasting gallbladder volume increased with time after surgery (r = +0.82, p = 0.047). Perception of satiety, abdominal fullness, and epigastric pain after ingestion of the test meal were all significantly greater in patients than in controls. Erythromycin significantly enhanced gallbladder emptying during fasting (p = 0.001) and postprandially in both patients and controls (0.002

AB - OBJECTIVE: Gastrectomy might be a risk factor for cholelithiasis and gallbladder stasis might play a major role. We studied fasting and postprandial gallbladder motility with 600 mg oral erythromycin or placebo in gastrectomized patients (with and without gallstones) and controls. METHODS: Seventeen patients operated on for gastric cancer (subtotal gastrectomy: n = 10, total gastrectomy: n = 7) were compared with 20 sex- and body-size matched healthy controls. Subjects randomly received erythromycin or placebo 30 min before the ingestion of a standard 200 ml liquid test meal. Gallbladder volume was estimated by ultrasonography until 120 min after test meal. A visual analog scale monitored GI perception of appetite, satiety, nausea, abdominal fullness and epigastric pain. RESULTS: Gastrectomized patients had increased fasting gallbladder volume (35.9 ± 3.4 ml versus 21.0 ± 1.4 ml, p = 0.0005) with faster postmeal emptying (T/2 14.8 ± 1.1 min versus 23.5 ± 1.5 min, p = 0.00019) than controls. Six patients developed small and asymptomatic gallstones, which did not influence gallbladder motility. In these patients, fasting gallbladder volume increased with time after surgery (r = +0.82, p = 0.047). Perception of satiety, abdominal fullness, and epigastric pain after ingestion of the test meal were all significantly greater in patients than in controls. Erythromycin significantly enhanced gallbladder emptying during fasting (p = 0.001) and postprandially in both patients and controls (0.002

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