Erythromycin accelerates solid emptying at the expense of gastric sieving

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Erythromycin stimulates antral contractions, mimicking interdigestive migrating motor complex (MMC) phase III.
• Fed motility involves submaximal contractions for solid fragmentation (trituration) and gastric sieving (>0.5 mm).

Purpose of the Study:

• To test if erythromycin-accelerated gastric emptying leads to the passage of inadequately triturated solids (>0.05 mm) into the duodenum.
• To investigate the effect of erythromycin on gastric sieving mechanisms.

Main Methods:

• Utilized dogs with duodenal fistulas to collect gastric effluent.
• Administered erythromycin and compared gastric emptying and particle size distribution against a saline control.

Main Results:

• Erythromycin significantly accelerated gastric emptying compared to the control (P < 0.05).
• A much larger percentage of chyme in the >0.5 mm fraction was observed with erythromycin (63% ± 9%) versus controls (7% ± 1%) (P < 0.01).
• Solids were emptied as large chunks with erythromycin, unlike the fine gruel seen in controls.

Conclusions:

• Erythromycin accelerates gastric emptying.
• This acceleration occurs at the expense of effective gastric sieving, leading to the passage of larger solid particles.
• The drug impairs the stomach's ability to reduce solid particle size before duodenal transit.