Effect of a proton pump inhibitor on postprandial gastric volume, emptying and symptoms in healthy human subjects: a pilot study.

Abstract

BACKGROUND:

In consensus guidelines, proton pump inhibitors (PPIs) are recommended for the treatment of functional dyspepsia. It is unclear whether PPIs change gastric volume or emptying.

AIM:

To assess the effect of a PPI, rabeprazole, on gastric volume and emptying and postprandial symptoms.

METHODS:

In a double-blind, parallel-group placebo-controlled trial, 13 healthy participants were randomized to rabeprazole, 20 mg b.d., or placebo. On day 3, fasting gastric volume was measured using intravenous (99m)Tc-pertechnate and single photon emission computed tomography (SPECT). After the last dose of study medication, an (111)In-chloride egg meal (300 kcal) was ingested, and postprandial gastric volume and emptying were measured by SPECT. Symptom ratings using a visual analogue scale (fullness, nausea, bloating, abdominal pain, aggregate score) were obtained at baseline and 15, 30, 45, 60 and 75 min postprandially. Group comparisons were performed using Mann-Whitney rank sum test.

RESULTS:

There were no statistically significant differences in gastric volume or emptying in the two groups. However, there was a borderline increase in gastric volume with rabeprazole compared with placebo. Rabeprazole treatment reduced aggregate postprandial symptoms, particularly fullness, 30 min after the meal (P = 0.01).

CONCLUSIONS:

In healthy participants, rabeprazole, 20 mg b.d., did not significantly change gastric emptying, but reduced symptoms and had a borderline effect on gastric volume postprandially. The mechanism of reduced postprandial symptoms with a PPI requires further study.

• Authors: A B M Grudell, M Camilleri, D D Burton, D A Stephens
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 24 Issue 7 Pg. 1037-43 (Oct 01 2006) ISSN: 0269-2813 [Print] England
• PMID: 16984497 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Enzyme Inhibitors
• Proton Pump Inhibitors
• Rabeprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles (therapeutic use)
• Adult
• Double-Blind Method
• Dyspepsia (drug therapy)
• Enzyme Inhibitors (therapeutic use)
• Female
• Gastric Emptying (drug effects)
• Humans
• Male
• Postprandial Period (drug effects)
• Proton Pump Inhibitors
• Rabeprazole
• Stomach (drug effects)