Effect of erythromycin administration on upper gastrointestinal motility in scleroderma patients.
BACKGROUND
Gastrointestinal involvement is frequent in patients with scleroderma. Erythromycin, a macrolide antibiotic, has been shown to accelerate gastric emptying in normal subjects and diabetic patients. The present study investigated the effects of acute erythromycin administration on gastric and gallbladder motility in patients with scleroderma and gastrointestinal involvement.


METHODS
Twelve scleroderma patients and 14 healthy subjects were investigated. Each subject was investigated on 4 different days. Gastric and gallbladder emptying and gastric motility were determined by sonography and manometry, and the effect of 2 mg/kg/h erythromycin in fasted patients or after semisolid meal evaluated.


RESULTS
The half-time of gastric emptying in response to semisolid meal was 121.3 +/- 14.0 min (SE) in scleroderma patients and 45.7 +/- 10.4 min in healthy subjects (P < 0.01). The peak of gallbladder emptying occurred later in scleroderma patients (95.0 +/- 5.0 min) than in healthy subjects (45.0 +/- 8.0 min) (P < 0.01). Erythromycin stimulated gastric and gallbladder motility in fasted subjects, as shown by manometry and sonography, and accelerated gastric and gallbladder emptying when administered immediately before the meal (P < 0.01).


CONCLUSIONS
Erythromycin accelerates gastric and gallbladder emptying in scleroderma patients and might be helpful in the treatment of gastrointestinal motor abnormalities in these patients.
Fiorucci
S
S
Gastroenterology and Digestive Endoscopy Clinic, University of Perugia, Italy.
Distrutti
E
E
Bassotti
G
G
Gerli
R
R
Chiucchiù
S
S
Betti
C
C
Santucci
L
L
Morelli
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004435:Eating; D004917:Erythromycin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D005215:Fasting; D005260:Female; D016473:Gallbladder Emptying / Q000187:drug effects*; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography
C010948:erythromycin lactobionate; D004917:Erythromycin