Influence of a lipase inhibitor on gastric sensitivity and accommodation to an orally ingested meal.
BACKGROUND
Intraduodenal administration of lipids, through lipid digestion and release of cholecystokinin (CCK), induces viscero-visceral reflexes that affect gastric tone and sensitivity. It is unclear whether the same mechanisms control gastric function after an orally ingested meal.


OBJECTIVE
To evaluate the effect of orlistat, a selective lipase inhibitor, on gastric response to an orally administered meal.


METHODS
Eighteen healthy volunteers participated in this study. They were treated for 5 days with orlistat (120 mg) or placebo t.d.s. in a double-blind randomized crossover design. During treatment, all subjects underwent a gastric barostat study, measurement of plasma CCK levels and a satiety drinking test.


RESULTS
Although CCK plasma levels were significantly decreased, pre-treatment with orlistat failed to affect gastric compliance (72 +/- 6 mL/mm Hg and 64 +/- 6 mL/mm Hg, NS), gastric sensitivity (discomfort threshold 12.2 +/- 0.6 mm Hg vs. 10.9 +/- 0.6 mm Hg above minimal distending pressure, NS) or gastric accommodation (172 +/- 41 mL vs. 206 +/- 49 mL, NS) to an orally ingested meal. Furthermore, orlistat pre-treatment had no significant effect on the amount of calories ingested during a satiety drinking test (1329 +/- 88 kcal vs. 1217 +/- 115 kcal, NS).


CONCLUSIONS
Administration of a lipase inhibitor does not affect gastric compliance, sensitivity to distension and accommodation to an orally ingested meal, and does not influence meal-induced satiety.
Demarchi
B
B
Department of Internal Medicine, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.
Vos
R
R
Deprez
P
P
Janssens
J
J
Tack
J
J
D000222:Adaptation, Physiological / Q000502:physiology; D000293:Adolescent; D000328:Adult; D019440:Anti-Obesity Agents / Q000494:pharmacology; D002766:Cholecystokinin / Q000097:blood; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004435:Eating / Q000502:physiology*; D004791:Enzyme Inhibitors / Q000494:pharmacology*; D005215:Fasting / Q000502:physiology; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D006801:Humans; D007783:Lactones / Q000494:pharmacology*; D008049:Lipase / Q000037:antagonists & inhibitors*; D008297:Male; D000077403:Orlistat; D019518:Postprandial Period / Q000502:physiology; D011312:Pressure; D012527:Satiation / Q000187:drug effects; D013270:Stomach / Q000187:drug effects* / Q000502:physiology
D019440:Anti-Obesity Agents; D004791:Enzyme Inhibitors; D007783:Lactones; D002766:Cholecystokinin; D000077403:Orlistat; D008049:Lipase