Influence of ghrelin on gastric emptying and meal-related symptoms in idiopathic gastroparesis.
BACKGROUND
Ghrelin, the endogenous ligand of the growth hormone secretagogue receptor, is released from the stomach. Animal studies suggest that ghrelin stimulates gastrointestinal motor activity.


OBJECTIVE
To investigate the influence of ghrelin on gastric emptying rate and meal-related symptoms in idiopathic gastroparesis.


METHODS
In six patients with idiopathic gastroparesis, a breath test was used to measure gastric emptying rates (t(1/2)) for solids and liquids after administration of saline or ghrelin 40 microg/30 min in a double-blind, randomized fashion. At each breath sampling, the patient was asked to grade the intensity of six different symptoms (epigastric pain, bloating, postprandial fullness, nausea, belching and epigastric burning) and these were added to obtain meal-related symptom severity score.


RESULTS
Ghrelin significantly enhanced liquid emptying (t(1/2): 86 +/- 7 vs. 53 +/- 6 min, P = 0.02) and tended to enhance solid emptying (144 +/- 45 vs. 98 +/- 15 min, P = 0.06). Ghrelin pre-treatment significantly decreased cumulative meal-related symptom score (196 +/- 30 vs. 136 +/- 23, P = 0.04) and individual scores for fullness (55 +/- 8 vs. 39 +/- 8, P = 0.02), and for pain (40 +/- 8 vs. 16 +/- 5, P < 0.05).


CONCLUSIONS
In idiopathic gastroparesis, administration of ghrelin enhances gastric emptying and improves meal-related symptoms. These observations suggest a potential for ghrelin receptor agonists in the treatment of gastroparesis.
Tack
J
J
Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium. jan.tack@med.kuleuven.ac.be
Depoortere
I
I
Bisschops
R
R
Verbeke
K
K
Janssens
J
J
Peeters
T
T
D001944:Breath Tests / Q000379:methods; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004415:Dyspepsia / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D018589:Gastroparesis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D054439:Ghrelin; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D036361:Peptide Hormones / Q000008:administration & dosage*; D019518:Postprandial Period; D013270:Stomach / Q000503:physiopathology; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D054439:Ghrelin; D036361:Peptide Hormones; D019382:Human Growth Hormone