Effects of Proton Pump Inhibitors andH2Receptor Antagonists on the Ileum Motility

Atilla Kurt,İhsan Bağcivan,Cengiz Aydın,Omer Topcu,Tijen Kaya,Ayhan Koyuncu,Ahmet Altun

doi:10.1155/2011/218342

Atilla Kurt, İhsan Bağcivan + Show 5 more

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https://doi.org/10.1155/2011/218342

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Abstract

Objectives. To investigate the effects of proton pump inhibitors (PPIs) and H2 receptor antagonists on ileum motility in rats with peritonitis and compare changes with control group rats. Methods. Peritonitis was induced by cecal ligation and puncture in 8 rats. Another of 8 rats underwent a sham operation and were accepted as controls. Twenty-four hours later after the operation, the rats were killed, and their ileum smooth muscle was excised and placed in circular muscle direction in a 10 mL organ bath. Changes in amplitude and frequency of contractions were analyzed before and after PPIs and H2 receptor blockers. Results. PPI agents decreased the motility in a dose-dependent manner in ileum in both control and intraabdominal sepsis groups. While famotidine had no significant effect on ileum motility, ranitidine and nizatidine enhanced motility in ileum in both control and intraabdominal sepsis groups. This excitatory effect of H2 receptor antagonists and inhibitor effects of PPIs were significantly high in control group when compared to the peritonitis group. The inhibitor effect of pantoprazole on ileum motility was significantly higher than the other two PPI agents. Conclusions. It was concluded that H2 receptor antagonists may be more effective than PPIs for recovering the bowel motility in the intraabdominal sepsis situation.

Highlights

Sepsis is a systemic response to infection and inflammation
We aimed to investigate the effects of pump inhibitors (PPIs) and H2 receptor blockers on ileum motility in both normal and peritonitis situations
Contractions induced by 80 mmol/L KCl were not significantly different between the peritonitis group and the control group in isolated ileum smooth muscle segments which indicated that muscle segments from both groups worked properly (Figure 1(a))

Summary

Introduction

Sepsis is a syndrome that affects the public health system and represents a challenge to health care providers and managers. Epidemiological data revealed a high incidence of sepsis in patients hospitalized in intensive care units (ICU) compared with the occurrence of disease in general population [4, 5]. Dysmotility of the gastrointestinal tract is a major complication in critically ill patients in intensive care units (ICU). This dysmotility manifests itself as inhibition of gastrointestinal motility, and rarely as hypermotility [6]. Impaired motility in critically ill patients can be caused by intestinal ischemia, electrolyte imbalances, peritoneal injury, abdominal surgery, lower-lobe pneumonia, pancreatitis, cholecystitis, intraabdominal abscesses, and medications (opiates, dopamine, diltiazem, verapamil, and anticholinergics) [7]

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