title: Erythromycin lacks colon prokinetic effect in children with functional gastrointestinal disorders: a retrospective study.
abstract: 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.
authors: 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
authors: Narayanan
authors: N
authors: Venkatasubramani
authors: Colin D
authors: CD
authors: Rudolph
authors: Manu R
authors: MR
authors: Sood
mesh_terms: 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
chemical_list: D005765:Gastrointestinal Agents; D011964:Receptors, Gastrointestinal Hormone; D018013:Receptors, Neuropeptide; C050802:motilin receptor; C010948:erythromycin lactobionate; D004917:Erythromycin