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Trimebutine-induced phase III-like activity in infants with intestinal motility disorders
N Boige1, G Cargill, L Mashako
1Service de Gastroentérologie Pédiatrique, Hôpital Bretonneau, Paris, France.
Insights
Trimebutine stimulated migrating motor complexes in children with severe digestive dysmotility. This drug shows potential for treating motility disorders in infants requiring total parenteral nutrition.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Research
- Pharmacology
Background:
- Severe digestive pathology in infants often presents with dysmotility, necessitating total parenteral nutrition.
- Conditions include enteropathy post-intestinal resection and intestinal pseudoobstruction, leading to impaired gut function.
Purpose of the Study:
- To investigate the effect of trimebutine on duodenal motility in pediatric patients with severe digestive dysmotility.
- To assess if trimebutine can induce organized motor activity, specifically phase III of the interdigestive cycle.
Main Methods:
- Duodenal manometric recordings were conducted in five male infants with severe digestive pathology.
- Basal fasting recordings were analyzed for interdigestive activity, followed by intravenous administration of trimebutine (3 mg/kg).
Main Results:
- Basal recordings revealed disorganized interdigestive activity, absent migrating motor complexes, and hypomotility compared to controls.
- Trimebutine induced a phase III-like activity in four of five patients, characterized by specific frequency and duration.
- This induced activity showed aboral propagation and was followed by peristalsis in some cases.
Conclusions:
- Trimebutine effectively stimulated phase III-like activity in the duodenum of infants with severe digestive dysmotility.
- The findings suggest trimebutine's potential therapeutic role in managing motility disorders in this vulnerable pediatric population.
- Further research is warranted to explore trimebutine's efficacy and safety in treating pediatric gastrointestinal dysmotility.
Abstract:
Duodenal manometric recordings were performed in five male children (mean age 11.7 +/- 6.8 months) suffering from severe digestive pathology with clinical findings of dysmotility; they required total parenteral nutrition: one case of enteropathy following intestinal resection for congenital small bowel atresia, and four cases of intestinal pseudoobstruction. The basal 3-h fasting recordings showed complete disorganization of interdigestive activity characterized by an absence of migrating motor complexes and a marked basal hypomotility with motor indices lower than in control subjects. Intravenous trimebutine (3 mg/kg) produced a phase III-like activity 88 +/- 121 s after administration in four cases. The activity lasted 236 +/- 105 s and had a mean frequency of 11.75 +/- 0.86 waves/min. It was propagated aborally in the two patients having two duodenal recording sites. Trimebutine-induced phase III activity was followed by signs of peristalsis in two patients.