Rabeprazole delays gastric emptying of a nutrient liquid.
BACKGROUND
It is generally considered that gastric acid suppression delays gastric emptying of solid meals because gastric hypoacidity impairs peptic digestion and antral triturition. Rabeprazole is one of the most potent acid suppressants. We conducted this cross-over study to investigate if rabeprazole delays gastric emptying of liquid nutrients, for which peptic digestion is unnecessary.


METHODS
On two randomized occasions, 13 healthy male volunteers underwent the (13)C-acetate breath test following ingestion of a 300 kcal-liquid meal. On one occasion, they had received 20 mg rabeprazole for the preceding 2 days and 1 h before the test. On another, they took no pretreatment. Based on 4 h breath samples, the half (13)CO(2) excretion time (t(1/2b)) and the time of maximal excretion (t(max)) were calculated as overall measures of gastric emptying. In addition, time profiles of gastric emptying were generated using the Wagner-Nelson analytical method, which creates the gastric emptying curve as accurately as the scintigraphy.


RESULTS
Rabeprazole significantly prolonged t(max) but unchanged t(1/2b). The gastric emptying profiles showed that rabeprazole evoked a segmental slowing of gastric emptying during 0.5-1.25 h of post-meal ingestion.


CONCLUSIONS
Rabeprazole suppresses gastric emptying of a liquid nutrient 0.5 h after meal ingestion. We have speculated that: (i) rabeprazole delays gastric emptying via a mechanism other than acid-pepsin maldigestion; and (ii) rabeprazole may intensify the post-gastric feedback regulation system (>0.5 h of post-meal).
Sanaka
Masaki
M
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. sanaka.koma.@cick.jp
Anjiki
Hajime
H
Yamamoto
Takatsugu
T
Kuyama
Yasushi
Y
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000494:pharmacology*; D000284:Administration, Oral; D000328:Adult; D001628:Beverages; D001944:Breath Tests; D002245:Carbon Dioxide / Q000378:metabolism; D002247:Carbon Isotopes; D018592:Cross-Over Studies; D005526:Food, Formulated; D005744:Gastric Acid / Q000378:metabolism*; D005746:Gastric Emptying / Q000187:drug effects*; D006801:Humans; D008297:Male; D010434:Pepsin A / Q000378:metabolism; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D006180:Proton-Translocating ATPases / Q000037:antagonists & inhibitors* / Q000378:metabolism; D064750:Rabeprazole; D013270:Stomach / Q000187:drug effects* / Q000201:enzymology
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D002247:Carbon Isotopes; D054328:Proton Pump Inhibitors; D002245:Carbon Dioxide; D064750:Rabeprazole; D010434:Pepsin A; D006180:Proton-Translocating ATPases