Effect of acute and chronic levosulpiride administration on gastric tone and perception in functional dyspepsia.
BACKGROUND
Altered visceral perception is common in functional dyspepsia (FD). Dopaminergic pathways control gastrointestinal motility, but whether they modulate visceral sensitivity is unknown.


OBJECTIVE
To investigate whether levosulpiride, a D2 antagonist, modulates gastric sensitivity and compliance in dyspeptic patients.


METHODS
Eight healthy subjects and 16 dyspeptic patients underwent graded gastric distensions using a tensostat. In dyspeptic patients the same isotonic distensions were repeated during either levosulpiride or saline administration. Eight FD patients were evaluated after 4-week treatment with oral levosulpiride. Gastrointestinal symptoms were evaluated using a 100 mm visual analogue score. Perception was scored on a scale of 0 to 6.


RESULTS
Although healthy subjects and FD patients had similar gastric compliance, FD patients tolerated lower tension levels. At the same distending tension levels, levosulpiride decreased gastric compliance and perception score (14 +/- 6% and 38 +/- 10% change, respectively; P < 0.05 vs. saline) only in FD patients. Isotonic distensions exhibited very reproducible perception. Chronic levosulpiride administration significantly reduced dyspeptic symptoms and increased discomfort threshold.


CONCLUSIONS
Compared with healthy subjects, FD patients show marked gastric hypersensitivity. In FD patients levosulpiride decreased the perception of gastric distension with an action unrelated to change of gastric tone. Chronic levosulpiride administration significantly ameliorates gastrointestinal symptoms and increases the discomfort threshold.
Distrutti
E
E
Gastroenterology Unit, University of Perugia, GiEnne Pharma, Milano, Italy. eleonoradistrutti@katamail.com
Fiorucci
S
S
Hauer
S K
SK
Pensi
M O
MO
Vanasia
M
M
Morelli
A
A
D000328:Adult; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004415:Dyspepsia / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects* / Q000502:physiology; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009129:Muscle Tonus / Q000187:drug effects; D011312:Pressure; D015203:Reproducibility of Results; D013270:Stomach / Q000187:drug effects* / Q000503:physiopathology; D013469:Sulpiride / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology* / Q000627:therapeutic use; D011795:Surveys and Questionnaires
D005765:Gastrointestinal Agents; D013469:Sulpiride; C078143:levosulpiride