Effects of proton pump inhibitors on gastric emptying: a systematic review.
The proton pump inhibitor (PPI) is widely used for the treatment of gastroesophageal reflux disease, peptic ulcer diseases, and functional dyspepsia. The pathogenesis of these acid-related and/or functional upper gastrointestinal disorders is potentially associated with abnormal gastric emptying. To date, variable effects of PPIs on gastric emptying have been reported. Therefore, it is relevant to gather and analyze published information on this topic. A systematic literature search has been performed, showing that the delaying effect of PPIs on gastric emptying of solid meals is consistent, whereas the effect of PPIs on the emptying of liquids is inconsistent. The underlying mechanisms whereby PPIs may affect gastric emptying have been discussed, most of which still remain hypothetic. Gastric emptying of solids involves a process of peptic hydrolysis. PPIs impair the hydrolytic digestion by inhibiting acid-dependent peptic activity, thereby delaying the solid emptying. Gastric emptying of liquids largely depends on volume and energy density of intragastric contents. PPIs variably modify the volume and the energy density by reducing gastric fluid secretion, thereby modifying the liquid emptying in an unpredictable manner. Hypergastrinemia has been considered to delay gastric emptying, but it seems of minor importance in the regulation of gastric emptying during PPI use. The delayed emptying of solids due to PPI therapy may have clinical implications in the management of gastroesophageal reflux disease, functional dyspepsia, as well as diabetes.
Sanaka
Masaki
M
Department of General Medicine and Emergency Care, Toho University School of Medicine, Omori Hospital, 6-11-1, Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan. sanaka-m@med.toho-u.ac.jp
Yamamoto
Takatsugu
T
Kuyama
Yasushi
Y
D000818:Animals; D004063:Digestion / Q000187:drug effects*; D004415:Dyspepsia / Q000188:drug therapy; D019317:Evidence-Based Medicine; D005744:Gastric Acid / Q000378:metabolism*; D005746:Gastric Emptying / Q000187:drug effects*; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D005767:Gastrointestinal Diseases / Q000188:drug therapy*; D006801:Humans; D006868:Hydrolysis; D009197:Myenteric Plexus / Q000187:drug effects / Q000503:physiopathology; D010437:Peptic Ulcer / Q000188:drug therapy; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D013270:Stomach / Q000187:drug effects* / Q000294:innervation / Q000503:physiopathology
D054328:Proton Pump Inhibitors