Abstract
The evaluation of agents potentially accelerating gastric emptying in gastric stasis syndromes is time-consuming. Since a previous study showed that emptying is slowed after antecedent fat ingestion and intravenous cisapride abolishes this effect, we investigated whether emptying delayed by fat incorporated into a meal is reversed by cisapride and thus could serve as a model for such evaluations. Twelve healthy males received, under double-blind conditions, 30 mg cisapride rectally or placebo, and 3 hr thereafter a semisolid meal of low (9.2 g) or high (37.9 g) fat content. The sequence of combinations placebo/low-fat meal, placebo/high-fat meal, and cisapride/high-fat meal was randomized. Gastric emptying and antral motility were recorded scintigraphically. After placebo/high-fat, emptying was significantly slower (P<0.05) than after placebo/low-fat. After cisapride/high-fat, emptying was significantly faster (P<0.01) than after placebo/high-fat and similar to that after placebo/low-fat. Antral motility was little affected. The slow emptying of a high-fat meal thus seems a suitable model for the evaluation of prokinetic drug effects.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Horowitz M, Harding PE, Chatterton BE, Collins PJ, Shearman DJC: Acute and chronic effects of domperidone on gastric emptying in diabetic autonomic neuropathy. Dig Dis Sci 30:1–9, 1985
Horowitz M, Maddern GJ, Maddox A, Wishart J, Chatterton BE, Shearman DJC: Effect of cisapride on gastric and esophageal emptying in progressive systemic sclerosis. Gastroenterology 93:311–315, 1987
Horowitz M, Maddox A, Maddern GJ, Wishart J, Collins PJ, Shearman DJC: Gastric and esophageal emptying in dystrophia myotonica. Effect of metoclopramide. Gastroenterology 92:570–577, 1987
Stacher G, Bergmann H, Wiesnagrotzki S, Kiss A, Schneider C, Mittelbach G, Gaupmann G, Höbart J: Intravenous cisapride accelerates delayed gastric emptying and increases antral contraction amplitude in patients with primary anorexia nervosa. Gastroenterology 92:1000–1006, 1987
Berkowitz DM, McCallum RW: Interaction of levodopa and metoclopramide on gastric emptying. Clin Pharmacol Ther 27:414–420, 1980
Müller-Lissner SA, Fraas C, Härtl A: Cisapride offsets dopamine-induced slowing of fasting gastric emptying. Dig Dis Sci 31:807–810, 1986
Hunt JN, Stubbs DF: The volume and energy content of meals as determinants of gastric emptying. J Physiol (London) 245:209–225, 1975
Kroop HS, Long WB, Alavi A, Hansell JR: Effects of water and fat on gastric emptying of solid meals. Gastroenterology 77:997–1000, 1979
Valenzuela JE, Defilippi C: Inhibition of gastric emptying in humans by secretin, the octapeptide of cholecystokinin, and intraduodenal fat. Gastroenterology 81:898–902, 1981
Collins PJ, Heddle R, Horowitz M, Read NW, Dent J, Chatterton BE: The effect of intraduodenal lipid on gastric emptying and intragastric distribution of a solid meal. Gastroenterology 90:1377, 1986 (abstract)
Stacher G, Bergmann H, Gaupmann G, Schneider C, Kugi A, Höbart J, Binder A, Steiner-Mittelbach G: Fat preload delays gastric emptying: Reversal by cisapride. Br J Clin Pharmacol 30:839–845, 1990
Schuurkes JAJ, van Nueten JM, van Daele PGH, Reyntjens AJ, Janssen PAJ: Motor stimulating properties of cisapride on isolated gastrointestinal preparations of the guinea pig. J Pharmacol Exp Ther 234:775–783, 1985
Feldman M, Smith HJ: Effect of cisapride on gastric emptying of indigestible solids in patients with gastroparesis diabeticorum: A comparison with metoclopramide and placebo. Gastroenterology 92:171–174, 1987
Jian R, Ducrot F, Ruskone A, Chaussade S, Rambaud JC, Modigliani R, Rain JD, Bernier JJ: Symptomatic, radionuclide and therapeutic assessment of chronic idiopathic dyspepsia. A double-blind placebo-controlled evaluation of cisapride. Dig Dis Sci 34:657–664, 1989
Jacobs F, Akkermans LMA, Oei Hong Yoe, Hoekstra A, Wittebol P: A radioisotope method to quantify the function of fundus, antrum, and their contractile activity in gastric emptying of a semisolid meal.In Motility of the Digestive Tract. M. Wienbeck (ed). New York, Raven Press, 1982, pp 233–240
Hunt JN, Spurrell WR: The pattern of emptying of the human stomach. J Physiol (London) 113:157–168, 1951
Geffers H, Meyer G, Bitter F, Adam WE: Analysis of heart function by gated blood pool investigation (camera cinematography).In Information Processing in Scintigraphy. Proceedings of the IVth International Conference, Orsay 15–19 July 1975. C Raynaud, A Todd-Pokropek, (eds). Saclay, Service de Documentation du CEN, 1976, pp 462–465
Games PA: Computer programs for robust analyses in multifactor analysis of variance designs. Educ Psychol Measur 35:147–152, 1975
Conover WJ: Practical Nonparametric Statistics. New York, John Wiley & Sons, 1971
Lilia P, Fried GM, Wiener I, Inoue K, Thompson JC: Comparison of concentrations of plasma cholecystokinin in pig, dog and man after food or intraduodenal fat. Gastroenterology 82:1118, 1982 (abstract)
Walsh JH, Lamers CB, Valenzuela JE: Cholecystokinin-octapeptidelike immunoreactivity in human plasma. Gastroenterology 82:438–444, 1982
Lee PC, Elitsur Y, Chaichanwanakul K, Leung YK, Lebenthal E: Cholecystokinin (CCK) release following high carbohydrate (C) and high fat (F) meal in humans. Lack of correlation to plasma insulin (I) and glucose (G). Gastroenterology 92:1498, 1987 (abstract)
Guedon C, Ducrotte P, Chayvialle JA, Lerebours E, Denis P, Colin R: Effects of intravenous and intraduodenal fat on jejunal motility and on plasma cholecystokinin in man. Dig Dis Sci 33:558–564, 1988
Liddle RA, Morita ET, Conrad CK, Williams JA: Regulation of gastric emptying in humans by cholecystokinin. J Clin Invest 77:992–996, 1986
Kleibeuker JH, Beekhuis H, Jansen JBMJ, Lamers CBHW, Piers DA: Infusion of physiologic doses of cholecystokinin inhibits gastric emptying of food in man. Gastroenterology 90:1495, 1986 (abstract)
Konturek SJ, Kwiecien N, Obtulowicz W, Kopp B, Oleksy J, Rovati L: Cholecystokinin (CCK) in the inhibition of gastric secretion and gastric emptying in humans. Gastroenterology 98:A368, 1990 (abstract)
Meyer BM, Beglinger C, Jansen JBMJ, Rovati LC, Werth BA, Hildebrand P, Zach D, Stalder GA: Role of cholecystokinin in regulation of gastrointestinal motor functions. Lancet 2:12–15, 1989
Cheng S, Novich K, Sankaran H, Deveney CW: Role of CCK in gastric emptying of liquids and solids in dogs. Gastroenterology 98:A336, 1990 (abstract)
Liberge M, Droy-Lefaix MT, Jutteau J, Bueno L: BIM-18216 elicits CCK antagonist properties in CCK8 and fat induced inhibition of gastric emptying in mice.In Abstracts I, The World Congress of Gastroenterology, August, 26–31, 1990, Sydney, Australia (abstract)
Janisch HD, Thies P, Wolf KU, Hampel KE: Gastric emptying and plasma VIP in response to oil in the stomach and the influence of cisapride.In Abstracts Submitted for the XI International Symposium on Gastrointestinal Motility, September 7–11, 1987, Oxford, England, Oxford, 1987, p 205 (abstract)
Weisbrodt NW, Wiley JN, Overholt BF, Bass P: A relation between gastroduodenal muscle contractions and gastric emptying. Gut 10:543–548, 1969
Kelly KA, Code CF: Effect of transthoracic vagotomy on canine gastric electrical activity. Gastroenterology 57:51–58, 1969
White CM, Poxon V, Alexander-Williams J: Effects of nutrient liquids on human gastroduodenal motor activity. Gut 24:1109–1116, 1983
Hasler W, Bowling B, Owyang C: Intraduodenal lipids induce pyloric contractions: role of cholecystokinin and the cholinergic and opiate pathways. Gastroenterology 96:A200, 1989 (abstract)
Houghton LA, Read NW, Heddle R, Maddern GJ, Downton J, Toouli J, Dent J: Motor activity of the gastric antrum, pylorus, and duodenum under fasted conditions and after a liquid meal. Gastroenterology 94:1276–1284, 1988
Heddle R, Dent J, Read NW, Houghton LA, Toouli J, Horowitz M, Maddern GJ, Downton J: Antropyloroduodenal motor responses to intraduodenal lipid infusion in healthy volunteers. Am J Physiol 254:G671-G679, 1988
Fone DR, Horowitz M, Read NW, Dent J, Maddox A: The effect of terminal ileal triglyceride infusion on gastroduodenal motility and the intragastric distribution of a solid meal. Gastroenterology 98:568–575, 1990
Smith AWM, Code CF: The effect of an ordinary and of an excessively fatty breakfast on human gastric antral motility. Gastroenterology 35:398–405, 1958
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Stacher, G., Granser, G.V., Bergmann, H. et al. Slow gastric emptying induced by high fat content of meal accelerated by cisapride administered rectally. Digest Dis Sci 36, 1259–1265 (1991). https://doi.org/10.1007/BF01307519
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01307519