Erythromycin stimulates phasic gastric contractility as assessed with an isovolumetric intragastric balloon pressure measurement.

Abstract

A novel technique to assess gastric motility by measuring the pressure in a low-volume intragastric balloon was developed to monitor (disordered) motility. We previously showed that this technique allows measuring pharmacologically induced inhibition of motility. In this study, we assessed whether it is possible to measure pharmacologically induced stimulation of gastric motility using 200mg erythromycin. Erythromycin is a highly effective stimulator of gastric emptying and contractility. After an overnight fast, a nasogastric balloon catheter was introduced in healthy subjects. After inflation with 120ml of air, the catheter was connected to a pressure sensor. Intraballoon pressure was continuously recorded for 4h. After a baseline recording of 2h, 200mg erythromycin was infused intravenously over 20min while the recording continued for 2h. Epigastric symptoms were surveyed on 100-mm visual analogue scales. Motility was quantified from the pressure recording as a gastric balloon motility index. Wilcoxon signed-rank tests were performed. Data are shown as median (interquartile range). Six subjects were enrolled and five completed the procedures (age: 28 (25-29) years, body mass index: 24.0 (23.8-24.5) kgm-2 ). One subject could not tolerate tube placement. Bloating, nausea, and epigastric sensation scores were 0 (0-3), 0 (0-1), and 1 (0-1) mm, respectively. Erythromycin significantly increased the motility index from 0.48 (0.41-0.51) to 0.79 (0.70-0.82) (p=0.03). Gastric motility assessed via pressure measurement in a low-volume intragastric balloon is able to detect pharmacologically stimulated motility in healthy subjects, which further validates this technique.