cqvip:Background and aims: Although delayed gastric emptying is considered a major pat hophysiological mechanism in functional dyspepsia, the efficacy of prokinetic drugs has not been established.Recent studies using macrolide prok- inetics were negative but receptor desensitisation may have played a role.The aim of the present study was to evaluate the influence on meal induced symptoms of acutely administered erythromycin in patients with gastroparesis. Methods: In 20 patients with functional dyspepsia, gastric emptying was studied twice using the 14C octanoic acid and 13C glycin breath test to establish the reproducibili ty of the test. Breath samples were taken before the meal and at 15 minute inter vals for a period of 240 minutes postprandially. At each breath sampling, the pa tient was asked to grade the intensity (0-3) of six dyspeptic symptoms. Twenty four patients (three men, mean age 43.5 (3) years) with dyspeptic symptoms and d elayed gastric emptying were studied twice after pretreatment with saline or ery thromycin intravenously.Results: Meal related symptom severity scores were reproducible. Treatment with erythromycin significantly enhanced solid and liquid gastric empt ying (t 1/2 146 (27) v 72 (7)minutes, respectively (p< 0.01), and 87 (6) v 63 (5 ) minutes(p< 0.001)). Only the severity of bloating was significantly improved b y erythromycin (23 (3.9) v 14.5 (2.7); p< 0.01); all other symptoms and the cumu lative meal related symptom score were not altered by erythromycin. Conclusions: In a setting where desensitisation played no role, erythromycin enhanced gastri c emptying was not associated with a beneficial effect on meal related symptom s everity.
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