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Intravenous Erythromycin Dramatically Accelerates Gastric Emptying in Gastroparesis Diabeticorum and Normals and Abolishes the Emptying Discrimination Between Solids and Liquids

Department of Nuclear Medicine, Department of Internal Medicine, Division of Gastroenterology, Department of Medical Research, University of Leuven, Leuven, Belgium

Correspondence: For reprints contact: Jean-Luc C. Urbain, MD, Nuclear Medicine Department, U.Z. Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.

ABSTRACT

Erythromycin, a macrolide antibiotic, has recently been shown to have a motilin like effect on gastrointestinal muscle strips. In this study, we have evaluated the effect of erythromycin on patients with delayed gastric emptying and healthy subjects using the dual radionuclide technique. Twelve patients with gastroparesis diabeticorum and ten healthy age- and sex-matched controls were studied. Gastric emptying of solids and liquids was determined using ^99mTc-SC scrambled egg and ¹¹¹In-DTPA in water. Following a baseline study and on a separate day, each patient and control received a 15-min i.v. perfusion of erythromycin starting at meal ingestion. Eleven out of the 12 patients were restudied after a 3-wk oral administration. In patients and controls, i.v. erythromycin dramatically accelerated gastric emptying of both solids and liquids which were emptied at the same rate. After chronic oral administration, solid and liquid emptying remained significantly accelerated. Erythromycin appears to be a very powerful gastrokinetic drug. Derived compounds with the gastrokinetic effect and without the antibiotic activity could be useful in dyspeptic patients with delayed gastric emptying.

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