Gastroparesis Essay

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Question:

What is the role of azithromycin for the treatment of gastroparesis?

Background:

Gastroparesis is a chronic condition that is characterized by the slow movement of gastric contents from the stomach to the small intestine, without evidence of obstruction. Symptoms include nausea, vomiting, abdominal pain, bloating, and lack of appetite. The most common cause of gastroparesis is diabetes mellitus, however most patients are diagnosed with an idiopathic cause.1

The treatment of gastroparesis aims to relieve symptoms and improve quality of life. Erythromycin is a macrolide antibiotic that improves gastric emptying through its prokinetic effects. When given orally many motilin agonists, including erythromycin, improve symptoms for several …show more content…

Patients included in the study had suspected functional or organic dysmotility, however patients were excluded if they had a prior history of obstruction or malignancy. The ADM test was divided into three phases: an initial fasting phase of 5-6 hours, a digestive phase during which patients were given two 470-calorie shakes, and a postprandial phase in which IV erythromycin and azithromycin were given. IV erythromycin 250 mg was administered to all patients followed by a 4-hour observation period; IV azithromycin 250 mg (n=15) or 500 mg (n=15) was then administered followed by another 4-hour observation period. Measured endpoints include: mean amplitude of antral contractions, duration of highest amplitude antral contractions, total duration of antral contractions, number of cycles per minute, and motility index …show more content…

There was no statistically significant difference in endpoints when comparing lower dose azithromycin to erythromycin. Results also showed no statistically significant difference between higher dose azithromycin and erythromycin with respect to total duration of antral contractions (p=0.11) or the number of cycles of antral contractions per minute (p=0.31). However, higher dose azithromycin showed increased mean amplitude of antral contractions (p=0.006), duration of highest amplitude antral contractions (p=0.03), and motility index (p=0.007), when compared to

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