scholarly journals The effect of octreotide on gastric emptying at a dosage used to prevent complications after pancreatic surgery: a randomised, placebo controlled study in volunteers

Gut ◽  
1997 ◽  
Vol 41 (6) ◽  
pp. 758-762 ◽  
Author(s):  
M I van Berge Henegouwen ◽  
Th M van Gulik ◽  
L M A Akkermans ◽  
J B M J Jansen ◽  
D J Gouma
Keyword(s):  
Gastric Emptying ◽  
Pancreatic Surgery ◽  
Lag Time ◽  
Controlled Study ◽  
Hydrogen Breath Test ◽  
Double Blind ◽  
Applied Potential Tomography ◽  
Octreotide Treatment ◽  
Prolonged Hospital ◽  
Cck Release

Background—Octreotide is used in many centres to prevent complications after pancreatic surgery. Delayed gastric emptying is a another complication occurring in around 30% of patients after pancreatoduodenectomy (PD) and causes prolonged hospital stay. The influence of octreotide on this complication is doubtful.Aims—To assess the effect of octreotide, at the clinical dosage used after pancreatic surgery, on gastric emptying in healthy volunteers.Subjects and methods—Eight healthy male volunteers (mean age 22.5 years) participated in this double blind, placebo controlled study. On day 1 subjects received 100 μg of octreotide or placebo subcutaneously, three times daily and on day 2, one hour after the fourth injection, gastric emptying, postprandial cholecystokinin (CCK) release, and mouth to caecum transit time (MCTT) were measured. This protocol was repeated after one week, in a crossover design. On the test day subjects received a liquid test meal (1.57 MJ/300 ml) and gastric emptying measurements were performed with applied potential tomography, a non-invasive, validated technique which measures gastric emptying through impedance differences. From the gastric emptying curves, lag time, t50, and postlag emptying rate were measured. MCTT was measured using the hydrogen breath test.Results—Lag time decreased from 29.6 (6.3) (mean (SEM)) to 12.2 (4.6) minutes (p<0.05) during octreotide treatment; t50 decreased from 87.8 (12.0) to 47.5 (8.2) minutes (p<0.02) and there was a trend towards an increased postlag emptying rate (0.8 to 1.6% per minute; p=0.07). MCTT increased from 150 (12.7) to 229 (17.9) minutes during octreotide treatment (p<0.01). Octreotide suppressed postprandial CCK release (p<0.05).Conclusions—MCTT was delayed by octreotide, suggesting impairment of small bowel transit. Octreotide administered at the clinical dosage for pancreatic surgery accelerates gastric emptying, mainly by shortening the lag time. Suppression of postprandial CCK release may be involved in this process. Octreotide administration is therefore not a contributing factor in the pathogenesis of delayed postoperative gastric emptying after PD and might even play a role in preventing this complication.

Opioid-induced Delay in Gastric Emptying 

1997 ◽  
Vol 87 (4) ◽  
pp. 765-770 ◽  
Author(s):  
D. B. Murphy ◽  
J. A. Sutton ◽  
L. F. Prescott ◽  
M. B. Murphy
Keyword(s):  
Gastric Emptying ◽  
Gastric Volume ◽  
Concentration Curve ◽  
Controlled Study ◽  
Opiate Antagonist ◽  
Double Blind ◽  
The Central Nervous System ◽  
The Mean ◽  
Opioid Medications ◽  
Induced Changes

Background Opioids delay gastric emptying, which in turn may increase the risk of vomiting and pulmonary aspiration. Naloxone reverses this opiate action on gastric emptying, but it is not known whether this effect in humans is mediated by central or peripheral opiate antagonism. The importance of peripheral opioid receptor antagonism in modulating opioid-induced delay in gastric emptying was evaluated using methylnaltrexone, a quaternary derivative of the opiate antagonist naltrexone, which does not cross the blood-brain barrier. Methods In a randomized, double-blind, crossover placebo-controlled study, 11 healthy volunteers were given either placebo (saline), 0.09 mg/kg morphine, or 0.09 mg/kg morphine plus 0.3 mg/kg methylnaltrexone on three separate occasions before ingesting 500 ml deionized water. The rate of gastric emptying was measured by two methods: a noninvasive epigastric bioimpedance technique and the acetaminophen absorption test. Results The epigastric bioimpedance technique was sufficiently sensitive to detect opioid-induced changes in the rate of gastric emptying. The mean +/- SD time taken for the gastric volume to decrease to 50% (t0.5) after placebo was 5.5 +/- 2.1 min. Morphine prolonged gastric emptying to (t0.5) of 21 +/- 9.0 min (P &lt; 0.03). Methylnaltrexone given concomitantly with morphine reversed the morphine-induced delay in gastric emptying to a t0.5 of 7.4 +/- 3.0 (P &lt; 0.04). Maximum concentrations and area under the concentration curve from 0 to 90 min of serum acetaminophen concentrations after morphine were significantly different from placebo and morphine administered concomitantly with methylnaltrexone (P &lt; 0.05). No difference in maximum concentration or area under the concentration curve from 0 to 90 min was noted between placebo and methylnaltrexone coadministered with morphine. Conclusions The attenuation of morphine-induced delay in gastric emptying by methylnaltrexone suggests that the opioid effect is mediated outside the central nervous system. Methylnaltrexone may have the potential to decrease the side effects of opioid medications, which are mediated peripherally, while maintaining the central analgesia effect of the opioid.

Load-dependent effects of duodenal lipid on antropyloroduodenal motility, plasma CCK and PYY, and energy intake in healthy men

2007 ◽  
Vol 293 (6) ◽  
pp. R2170-R2178 ◽  
Author(s):  
Amelia N. Pilichiewicz ◽  
Penny Papadopoulos ◽  
Ixchel M. Brennan ◽  
Tanya J. Little ◽  
James H. Meyer ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Energy Intake ◽  
Peptide Yy ◽  
Saline Control ◽  
Double Blind ◽  
Gastric Emptying Rate ◽  
The Mean ◽  
Small Intestinal ◽  
Healthy Males ◽  
Cck Release

Both load and duration of small intestinal lipid infusion affect antropyloroduodenal motility and CCK and peptide YY (PYY) release at loads comparable to and higher than the normal gastric emptying rate. We determined 1) the effects of intraduodenal lipid loads well below the mean rate of gastric emptying on, and 2) the relationships between antropyloroduodenal motility, CCK, PYY, appetite, and energy intake. Sixteen healthy males were studied on four occasions in double-blind, randomized fashion. Antropyloroduodenal motility, plasma CCK and PYY, and appetite perceptions were measured during 50-min IL (Intralipid) infusions at: 0.25 (IL0.25), 1.5 (IL1.5), and 4 (IL4) kcal/min or saline (control), after which energy intake at a buffet meal was quantified. IL0.25 stimulated isolated pyloric pressure waves (PWs) and CCK release, albeit transiently, and suppressed antral PWs, PW sequences, and hunger ( P < 0.05) but had no effect on basal pyloric pressure or PYY when compared with control. Loads ≥ 1.5 kcal/min were required for the stimulation of basal pyloric pressures and PYY and suppression of duodenal PWs ( P < 0.05). All of these effects were related to the lipid load ( R > 0.5 or < −0.5, P < 0.05). Only IL4 reduced energy intake (in kcal: control, 1,289 ± 62; IL0.25, 1,282 ± 44; IL1.5, 1,235 ± 71; and IL4, 1,139 ± 65 compared with control and IL0.25, P < 0.05). In conclusion, in healthy males the effects of intraduodenal lipid on antropyloroduodenal motility, plasma CCK and PYY, appetite, and energy intake are load dependent, and the threshold loads required to elicit responses vary for these parameters.

A Double-Blind Placebo-Controlled Study on the Effects of Omeprazole on Gut Hormone Secretion and Gastric Emptying Rate

1997 ◽  
Vol 32 (9) ◽  
pp. 900-905 ◽  
Author(s):  
L. Rasmussen ◽  
N. Qvist ◽  
E. Øsster-Jørgensen ◽  
J. F. Rehfeld ◽  
J. J. Holst ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Hormone Secretion ◽  
Controlled Study ◽  
Double Blind ◽  
Gastric Emptying Rate ◽  
Double Blind Placebo ◽  
Gut Hormone

scholarly journals The Effect of Continuous Intake of Lactobacillus gasseri OLL2716 on Mild to Moderate Delayed Gastric Emptying: A Randomized Controlled Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1852
Author(s):  
Toshihiro Ohtsu ◽  
Ken Haruma ◽  
Yumiko Ide ◽  
Atsushi Takagi
Keyword(s):  
Placebo Group ◽  
Gastric Emptying ◽  
Odds Ratio ◽  
Delayed Gastric Emptying ◽  
Controlled Study ◽  
Salivary Amylase ◽  
Double Blind ◽  
Gastric Emptying Rate ◽  
Lactobacillus Gasseri ◽  
Liquid Meal

Probiotics have been suggested to be effective for functional dyspepsia, but their effect on gastric motility is not clear. We evaluated the effect of Lactobacillus gasseri OLL2716 (LG21 strain) on mild to moderate delayed gastric emptying by a double-blind, parallel-group, placebo-controlled, randomized trial. Participants (n = 28) were randomly assigned to ingest LG21 strain-containing yogurt (LG21 strain group) or LG21 strain-free yogurt (placebo group) for 12 weeks. The 13C gastric emptying breath test was performed to measure the gastric emptying rate over time following ingestion of a liquid meal, and the time to reach the peak (Tmax) was used as an indicator of gastric emptying. We also measured the salivary amylase concentration, an indicator of autonomic dysfunction under stress. The per-protocol population (n = 27, male n = 4, female n = 23) was evaluated for efficacy. When a ≥30% reduction in the difference between participant’s Tmax and the Japanese mean Tmax was defined as an improvement, the odds ratio of improvement in delayed gastric emptying compared to placebo after 12 weeks was 4.1 (95% confidence interval, 0.8 to 20.2). Moreover, salivary amylase concentrations were significantly lower than in the placebo group, indicating an improvement in autonomic function. The present data were not enough to support the beneficial effects of the LG21 strain on delayed gastric emptying. However, if we define the odds ratio in further study investigated with a larger number of participants, LG21 strain might be expected to have some impact on delayed gastric emptying.

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