Tegaserod accelerates orocecal transit in patients with constipation-predominant irritable bowel syndrome.
OBJECTIVE
This study evaluated the effects of a partial 5-hydroxytryptamine (5-HT)(4) agonist, tegaserod, on gastric small bowel and colonic transit in constipation-predominant irritable bowel syndrome (IBS).


METHODS
After a 1 week run-in period, 24 patients with constipation-predominant IBS were randomized to 1 week of tegaserod, 2 mg twice daily, or placebo treatment. Scintigraphic gastric emptying, small bowel transit, and colonic transit were determined before administration of study drug and after 1 week on the medication. Colonic transit was also measured using radiopaque markers and a single radiograph on day 5.


RESULTS
Gastric emptying was unaltered by tegaserod. Proximal colonic filling at 6 hours, a measure of orocecal transit, was accelerated by tegaserod (70.4% +/- 1.3% [mean +/- SEM] vs. placebo, 46.4 +/- 1.9; P = 0.015). Proximal colonic emptying half-time and geometric center at 48 hours were also accelerated by tegaserod compared with baseline, but not compared with placebo. Mean colonic transit time was similar in both groups at baseline and after drug administration (tegaserod, 59.5 +/- 2.1 hours; placebo, 62.1 +/- 2.1 hours).


CONCLUSIONS
Tegaserod accelerates orocecal transit, tends to accelerate colonic transit, and deserves further study in patients with constipation-predominant IBS.
Prather
C M
CM
Gastroenterology Research Unit, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Camilleri
M
M
Zinsmeister
A R
AR
McKinzie
S
S
Thomforde
G
G
D000328:Adult; D000368:Aged; D003106:Colon / Q000000981:diagnostic imaging / Q000503:physiopathology; D003109:Colonic Diseases, Functional / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D003248:Constipation / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006146:Guanidines / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use*; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D011877:Radionuclide Imaging; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D013270:Stomach / Q000000981:diagnostic imaging / Q000503:physiopathology; D013997:Time Factors
D006146:Guanidines; D007211:Indoles; D017366:Serotonin Receptor Agonists; C105050:tegaserod