Gastric emptying response to variable oral erythromycin dosing in diabetic gastroparesis |
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Authors: | Steven G. Desautels MD Dr. William R. Hutson MD Paul E. Christian BS John G. Moore MD Fred L. Datz MD |
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Affiliation: | (1) From the Division of Gastroenterology and Hepatology, Department of Medicine, and Division of Nuclear Medicine, Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah.;(2) Division of Gastroenterology and Hepatology, University of Pittsburgh Medical Center, MUH, E 323, 200 Lothrop Street, 15213 Pittsburgh, Pennsylvania |
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Abstract: | Intravenous erythromycin has been shown to improve gastric emptying in diabetic gastroparesis. Oral erythromycin also accelerates gastric emptying, but to a lesser degree. To determine if this is a dose-dependent phenomenon, gastric emptying was measured in 10 insulin-requiring diabetic patients with gastroparesis after administration of either 250 mg or 1000 mg of erythromycin or placebo. The drugs were orally administered in a randomized, double-blind fashion 30 min prior to ingestion of a meal containing [99mTc]-sulfur colloid-labeled beef stew and [111In]DTPA-labeled orange juice. Anterior and posterior gastric images were recorded for 3 hr at 15-min intervals using an externally positioned gamma camera. The results demonstrated that both doses of oral erythromycin significantly improved solid-phase gastric emptying. The mean half-emptying time of solids was decreased from 151±40 min with placebo to 58±10 min and 40±9 min with 250 mg and 1000 mg of erythromycin, respectively. However, a dose-dependent relationship was not demonstrated with the two doses of erythromycin employed. These results suggest that for most patients with diabetic gastroparesis, a single 250-mg dose of erythromycin will significantly improve gastric emptying. It is possible that a dose-dependent relationship will be demonstrated with doses of erythromycin less than 250 mg. |
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Keywords: | gastric emptying diabetes mellitus erythromycin |
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