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Gastroparesis and Women

May 042013

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Women had slower gastric emptying rates than men according to a study of 20 men and 40 women. Premenopausal women, postmenopausal women, and postmenopausal women taking oral estrogen had slower gastric emptying than men. The antrum is the part of the stomach located near the entrance to the small bowel. Antral motility was measured during this study, and there was no difference between men and women.

Source:
Influence of gender and menopause on gastric emptying and motility.
Hutson WR, Roehrkasse RL, and Wald A. Gastroenterology. 1989 Jan;96(1):11-7.

A seperate study compared premenopausal women to age matched men. Their rate to empty half their gastric contents was thirty minutes longer than men. Dynamic antral scintigraphy uses nuclear medicine to measure to contractions in the antrum. Using this technique, the contractility of the mid-antrum was shown to be significantly lower in women.

Source:
Knight LC, Parkman HP, Brown KL, Miller MA, Trate DM, Maurer AH, and Fisher RS. Delayed gastric emptying and decreased antral contractility in normal premenopausal women compared with men. Am J Gastroenterol. 1997 Jun;92(6):968-75.

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Narcotics and vomiting. Methylnaltrexone reversal.

Uncategorized No Responses »

Mar 142013

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Opiates such as morphine can delay gastric emptying and intestinal transit.

Source:

Wood JD, and Galligan JJ. Function of opioids in the enteric nervous system. Neurogastroenterol Motil. 2004;16 Suppl 2:17-28.

Methylnalrexone is mu-opioid receptor antagonist which does not cross the blood brain barrier. It has been shown in a randomized study of 133 patients to induce defecation rapidly without reversing the central analgesic effects of opioids.

Source:

Thomas J, Karver S, Cooney GA, Chamberlain BH, Watt CK, Slatkin NE, Stambler N, Kremer AB, and Israel RJ. Methylnaltrexone for opioid-induced constipation in advanced illness. N Engl J Med. 2008 May 29;358(22):2332-43.

In a randomized, double-blind, crossover placebo-controlled study, analysis of patients given morphine or morphine and methylnaltrexone showed a reversal of the delay in gastric emptying.

Source:

Murphy DB, Sutton JA, Prescott LF, and Murphy MB. Opioid-induced delay in gastric emptying: a peripheral mechanism in humans. Anesthesiology. 1997 Oct;87(4):765-70.

Methylnaltrexone was not shown to prevent post-operative nausea and vomiting in a prospective double-blind trial.

Source:

Moerman I, Franck P, and Camu F. Evaluation of methylnaltrexone for the reduction of postoperative vomiting and nausea incidences. Acta Anaesthesiol Belg. 1995;46(3-4):127-32.

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TZP 102 Gastroparesis Phase 2a Trial

Medicine No Responses »

Mar 102013

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TZP-102 is an oral ghrelin receptor agonist which recently underwent a phase 2a randomized, double-blind trial with 92 patients showing no significant improvement in gastric emptying but did provide symptomatic relief. Other trials have also had no improvement in gastric emptying but symptom improvement.

Source:

Ejskjaer N, Wo JM, Esfandyari T, Mazen Jamal M, Dimcevski G, Tarnow L, Malik RA, Hellström PM, Mondou E, Quinn J, Rousseau F, and McCallum RW. A phase 2a, randomized, double-blind 28-day study of TZP-102 a ghrelin receptor agonist for diabetic gastroparesis. Neurogastroenterol Motil. 2013;25(2):e140-50.

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