Clinical ResearchProkinetic effects in patients with intestinal gas retention☆,☆☆,★
Section snippets
Participants
Twenty-eight patients with abdominal bloating as their predominant symptom and 14 healthy individuals without gastrointestinal symptoms (9 women and 5 men; age range, 21–35 years) participated in the study after giving written informed consent. Fourteen patients (12 women and 2 men; age range, 24–66 years) fulfilled criteria for IBS and the other 14 (11 women and 3 men; age range, 31–56 years) for functional bloating.4 All patients were symptomatic at the time of the study. The protocol for the
Gas transit and evacuation
In healthy subjects, evacuation of infused gas began within 30 minutes after starting the infusion. The initial gas retention progressively decreased, so that, by the end of the 2-hour infusion period, the volume of gas retained became nonsignificant (Figure 1).
Discussion
We have shown that, in patients with impaired gas transit featuring gas retention, abdominal symptoms, and distention, a potent prokinetic stimulus improved intestinal gas propulsion and evacuation. Furthermore, gas clearance was paralleled by improvement of both abdominal distention and symptoms.
In previous studies, we showed that gas retention can be experimentally produced in healthy subjects either by impairing intestinal propulsion, i.e., by IV glucagon, or by creating a high-resistance
Acknowledgements
The authors thank Nuria Ferrer and Isidre Casals, Serveis Cientifico-Tecnics of the Central University of Barcelona, for help in gas infrared absorbance analysis; Maite Casaus and Anna Aparici for technical support; and Gloria Santaliestra for secretarial assistance.
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Address requests for reprints to: Fernando Azpiroz, M.D., Digestive System Research Unit, Hospital General Vall d'Hebron, 08035-Barcelona, Spain. e-mail: [email protected]; fax: (34) 93 489 44 56.
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Supported in part by the Spanish Ministry of Science and Technology (grant BSA 2001-2584) and the National Institutes of Health (grant DK 57064). Dr. Caldarella was supported by a scholarship from the University of Chieti.
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Dr. Caldarella's present address is: Department of Internal Medicine, Hospital SS. Annunziata, 66100 Chieti, Italy.