Erythromycin lacks colon prokinetic effect in children with functional gastrointestinal disorders: a retrospective study.
BACKGROUND
Motilin, a peptide hormone has a direct excitatory effect on circular smooth muscle strips derived from the human colon. Reduced plasma motilin concentration has been reported in adults with chronic constipation. Erythromycin, a non-peptide motilin receptor agonist, induces phase 3 of the migrating motor complex (MMC) in the antro-duodenum and also reduces oro-cecal transit time. A pediatric study has reported an improvement in clinical symptoms of constipation following erythromycin administration, but the effect on colon motility in children has not been formally evaluated. We used colon manometry to study the effect of intravenous erythromycin lactobionate at 1 mg/kg on colon motility in ten children.


METHODS
We selected patients with normal antroduodenal and colon manometry studies that were performed simultaneously. All studies were performed for clinically indicated reasons. We quantified the effect of erythromycin on colon contraction by calculating the area under the curve (AUC).


RESULTS
The mean (SE of mean) AUC in the colon during the fasting, post-erythromycin and postprandial phases of the study was 2.1 mmHg/sec (0.35), 0.99 mmHg/sec (0.17) and 3.05 mmHg/sec (0.70) respectively. The AUC following erythromycin was significantly less compared to the fasting phase of the study (p < 0.01).


CONCLUSIONS
Erythromycin lacks colon prokinetic effect in children with chronic constipation evaluated by colon manometry.
Venkatasubramani
Narayanan
N
Division of Pediatric Gastroenterology and Nutrition, The Children's Hospital of Wisconsin and The Medical College of Wisconsin, Milwaukee, WI 53226, USA. nvenkata@mcw.edu
Rudolph
Colin D
CD
Sood
Manu R
MR
D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000187:drug effects* / Q000503:physiopathology*; D003248:Constipation / Q000188:drug therapy / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004917:Erythromycin / Q000031:analogs & derivatives / Q000494:pharmacology* / Q000627:therapeutic use; D005242:Fecal Incontinence / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005765:Gastrointestinal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000503:physiopathology*; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D008297:Male; D008365:Manometry; D009119:Muscle Contraction / Q000187:drug effects / Q000502:physiology; D009130:Muscle, Smooth / Q000187:drug effects / Q000502:physiology; D010528:Peristalsis / Q000187:drug effects / Q000502:physiology; D011964:Receptors, Gastrointestinal Hormone / Q000819:agonists; D018013:Receptors, Neuropeptide / Q000819:agonists; D012189:Retrospective Studies; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D011964:Receptors, Gastrointestinal Hormone; D018013:Receptors, Neuropeptide; C050802:motilin receptor; C010948:erythromycin lactobionate; D004917:Erythromycin