Intravenous erythromycin overcomes small intestinal feedback on antral, pyloric, and duodenal motility
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Cited by (68)
High-Dose Oral Erythromycin Decreased the Incidence of Parenteral Nutrition-Associated Cholestasis in Preterm Infants
2007, GastroenterologyCitation Excerpt :Although the exact mechanism in which erythromycin facilitates advancement of enteral feeding is not fully understood, there is substantial evidence to suggest that the prokinetic action is mediated via the motilin pathway principally at the levels of the stomach and proximal small bowel.51–53 Stimulation of this pathway results in increase in the proximal gastric tone,54 greater amplitude and more frequent antral contractions,55–58 suppression of pyloric contractions and consequently reducing outlet resistance,52 and increase in the frequency of duodenal contractions.59 Recent studies have indicated the presence of 2 main types of motilin receptors.60
Mechanoreceptors of the Proximal Stomach: Role in Triggering Transient Lower Esophageal Sphincter Relaxation
2004, GastroenterologyCitation Excerpt :The intravenous dose of a 4.8-μg/kg bolus followed by infusion of 9.6 μg · kg−1 · h−120,21 was therefore chosen for the main study. An intravenous dose of 3 mg/kg has most frequently been used in studies of gastric motility and emptying26–29 because it generates powerful gastric contractions and is well tolerated.27,28,30,31 Furthermore, it induces a significant increase in tone of the proximal stomach during fasting,32 which has also been shown at 0.75 or 1.5 mg/kg.33,34
Functional characteristics of the pylorus in patients undergoing pylorus-preserving gastrectomy for early gastric cancer
2002, SurgeryCitation Excerpt :Serial changes in basal pyloric pressure, the rate of IPPWs, and the mean amplitude of IPPWs were analyzed in the period from T = −15 to T = 55. The erythromycin induced phase III-like activity in the pylorus was defined as “a period of regular contractions, which lasted at least 1 minute and showed a temporal overlap with the duodenal phase III-like activity after erythromycin administration.”6,21 Phase III-like activity in the duodenum was defined as “the occurrence of regular contractions at a frequency ≥ 10/minute for at least 2 minutes, and was followed by at least 5 minutes of relative quiescence (phase I).”6,20
GI complications in patients receiving mechanical ventilation
2001, ChestCitation Excerpt :Prokinetic agents, such as erythromycin, have been shown to promote gastric emptying in patients receiving MV and should be considered once mechanical obstruction is excluded. Erythromycin, 200 mg once daily, can improve gastric motility in these patients by increasing the amplitude of antral contractions and improving antroduodenal coordination.129,130,131 While erythromycin acts via motilin receptors, an intact vagal pathway has been shown to be necessary for its GI effects.132,133
Effects of low doses of erythromycin on the <sup>13</sup>C Spirulina platensis gastric emptying breath test and electrogastrogram: A controlled study in healthy volunteers
2001, American Journal of GastroenterologyCitation Excerpt :Erythromycin’s effect on gastric emptying is associated with a reduction in the lag phase and an acceleration of the postlag emptying rate of solids (13, 14). These effects have been attributed to an increase in antral contractility (15–17) and fundic tone (18), and an inhibition in pyloric contractility resulting in an improvement in antropyloroduodenal coordination (15, 16). The effects of erythromycin on gastric motility have been extensively studied in animals and man; however, only limited data exist on the dose-related effects of erythromycin on gastric motor function.
AGA technical review on nausea and vomiting
2001, GastroenterologyCitation Excerpt :Although it has been recognized for some time that erythromycin, a macrolide, is associated with significant gastrointestinal effects, the possibility that these are related to the stimulation of motility was not recognized until recently. It is now clear that erythromycin exerts a dose-dependent stimulatory effect on foregut motility198 and inhibits isolated pyloric pressure waves and pyloric tone.199 These direct effects on contractile activity translate into acceleration of gastric emptying, abolition of the lag phase of solid emptying, emptying of nondigestible solids, and the induction of “dumping.”200-205