The Effect of Erythromycin in Gastric Emptying of Solids and Hypertonic Liquids in Healthy Subjects

We report our study of the effect of erythromycin on gastric emptying of solid and liquid meals in 10 healthy subjects. On different occasions, subjects consumed either a radiolabeled 50% glucose solution, or a radiolabeled standard solid meal after placebo, and after receiving 200 mg of erythromycin intravenously. Erythromycin accelerated the gastric emptying of the hypertonic liquid meal by significantly decreasing the duration of lag phase ( p < 0.0001), by significantly increasing the emptying rate at the postlag period ( p < 0.001), and by significantly decreasing the duration of the postlag period ( p < 0.0001) and the meal remaining in the stomach at 15 ( p < 0.05), 30 ( p < 0.001), and 60 ( p < 0.01) min postprandially. In addition, erythromycin administration induced a significant plasma fall at 15 ( p < 0.05) and 30 ( p < 0.01) min and a significant increase in pulse rate at 15 and 30 min ( p < 0.01) after consumption of the hypertonic glucose solution, whereas three subjects experienced symptoms suggesting dumping syndrome. Furthermore, erythromycin administration enhanced the gastric emptying of solids by almost abolishing the duration of lag phase ( p < 0.0001) and by reducing the overall t_1/2 of emptying ( p < 0.0001), whereas less food was retained in the stomach at 60 ( p < 0.001) and 120 ( p < 0.0001) min postprandially. Conversely, the postlag t_1/2 of the solid meal emptying was not affected by erythromycin, as compared to placebo. We conclude that erythromycin has gastrokinetic properties, affecting the gastric emptying of both liquids and solids.