Effect of trospium chloride on gastrointestinal motility in humans

The aim of this double-blind, placebo-controlled, cross-over study was to investigate the effect of trospium chloride on gall bladder contraction, gastric emptying of a liquid meal, gastrooesophageal reflux, and orocaecal transit time in healthy subjects. Gall bladder contraction was examined by ultrasonography before and after stimulation with two raw eggs. Gastric emptying was evaluated by an intubation technique and by sonography. To determine gastrooesophageal reflux and orocaecal transit time, 24-hour pH metry and a hydrogen breath test were used. The gall bladder ejection fractions were significantly lower after oral treatment with both 4 x 10 mg and 4 x 20 mg trospium compared to placebo, but no difference was seen between the two doses of drug. Gastric emptying of a liquid meal was significantly delayed after intake of 4 x 15 mg trospium, whilst the time course of the intragastric volume determined by ultrasound did not differ from that after placebo, suggesting an antisecretory effect of trospium on gastric secretion. The fractional time of oesophageal pH < 4 as a percentage of the entire 24-hour investigation period was significantly increased by treatment with trospium 3 x 15 mg per day. The orocaecal transit time of 10 g lactulose was significantly prolonged. Provided that the observed effects on gall bladder contraction, gastric emptying, and orocaecal transit time are reproduced in disease states, trospium should be regarded as a potentially useful antispasmodic agent.