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Double-Blind, Placebo-Controlled Study on Effects of Diclofenac Sodium and Indomethacin on Postprandial Gastric Motility in Man

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Abstract

Data from animal studies suggest thatNSAIDs-induced gastric damage may be due to increasedgastric motility. Such a mechanism, however, has neverbeen tested or demonstrated in man. We evaluated theeffects of two frequently prescribed NSAIDs,indomethacin and diclofenac sodium, on postprandialgastric motor activity (a physiologically reproduciblestimulus) in healthy volunteers to see whether thesecompounds increase gastric motility. Twenty-four healthyvolunteers of both sexes, 21-35 years of age, underwenta basal gastric motility recording. Thereafter, theywere randomized in three groups to receive either placebo, indomethacin (50 mg three times a day)or diclofenac sodium (50 mg three times a day) for aweek. At the end of the week, they underwent anidentical manometric study. Analysis of the motility tracings showed no difference in gastric antralmotility index and in amplitude of gastric antralcontractions after NSAIDs with respect to the basalstudy and to the placebo group. About 50% of subjects (two in the placebo group) complained of sideeffects. These were transient and mild, except in twosubjects taking indomethacin, in whom endoscopy wasnecessary; one of these had a small prepyloric ulcer. It is concluded that in man NSAID-relatedgastric damage is unlikely to be due to increasedgastric motility.

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REFERENCES

  1. Loeb DS, Ahlquist DA, Talley NJ: Manageme nt of gastroduodenopathy associated with use of nonsteroidal anti-inflammatory drugs. Mayo Clin Proc 67:354-364, 1992

    Google Scholar 

  2. Parise P, Agnelli G: Antipyretics analgesics. In:Side Effects of Drugs Annual 17. JK Aronson, CJ van Boxtel (eds). Amsterdam, Elsevier Science BV, 1993, pp 94-101

    Google Scholar 

  3. Sandor Z, Szabo S: Pharmacologic approaches and pathogenic basis for NSAID gastropathy: Preve ntion and treatment. Pract Gastroente rol 15:30-43, 1991

    Google Scholar 

  4. McCarthy DM: Pathogenic mechanisms of gastroduodenal injury: Nonsteroidal and anti-inflammatory drugs. Curr Opin Gastroenterol 7:976-980, 1991

    Google Scholar 

  5. Koop H: Neue Aspekte in der pathogenese des Gastroduode-nalulcus. Dtsch Med Wochenschr 117:1243-1246, 1992

    Google Scholar 

  6. Scheiman JM: Pathogenesis of gastroduodenal injury due to nonsteroidal antiinflammatory drugs: Implications for prevention and therapy. Semin ArthritisRheum 21:201-210, 1992

    Google Scholar 

  7. Wallace JL: Non-steroidal anti-inflammatory drug gastropathy and cytoprotection: Pathogenesis and me chanismsre-examined. Scand J Gastroente rol 27( suppl 192):3-8, 1992

    Google Scholar 

  8. Bjarnason I, Hayllar J, Macphe rson AJ, Russe l AS: Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Gastroenterology 104:1832-1847, 1993

    Google Scholar 

  9. Del Fave ro A: Anti-infl ammatory analgesics and drug used in rheumatoid arthritis and gout. In:Side Effects of Drugs Annual 17. JK Aronson, CJ van Boxtel (eds). Amsterdam, Elsevier Science BV, 1993, pp 102-119

    Google Scholar 

  10. Merse reau WA, Hinchey EJ: Synergism between acid and gastric contractile activity in the genesis of ulceration and hemorrhage in the phenylbutazone-tre ated rat. Surgery 90:516-522, 1981

    Google Scholar 

  11. Merse reau WA, Hinchey EJ: Prevention of phenylbutazone ulcer in the rat by glucose: Role of glycoprivic re ceptor system. Am J Physiol 242:G429-G432, 1982

    Google Scholar 

  12. Takeuchi K, Ue ki S, Okabe S: Importance of gastric motility in the pathogenesis of indomethacin-induced gastriclesions in rats. Dig Dis Sci 31:1114-1122, 1988

    Google Scholar 

  13. Mersereau WA, Hinchey EJ: Relationship between the gastric myoelectric and mechanical activity in the genesis of ulcers in indomethacin-insulin treated rats. Dig Dis Sci 33:200-208, 1988

    Google Scholar 

  14. Ue ki S, Takeuchi K, Okabe S: Gastric motility is an important factor in the pathogenesis of indomethacin-induced gastric mucosal lesions in rats. Dig Dis Sci 33:209-216, 1988

    Google Scholar 

  15. Frankhuizen AL, Bonta IL: Role of prostaglandins in tone and effector reactivity of the isolated rat stomach preparation. Eur J Pharmacol 31:44-52, 1975

    Google Scholar 

  16. Pantoja GL, De fi lippi C, Valenzuela JE, Csendes A: Nonsteroidal antiin¯ ammatory drugs: Effect on pyloric sphincter and duodenogastricreflux. Dig Dis Sci 24:217-220, 1979

    Google Scholar 

  17. Fioramonti J, Bueno L: Gastrointestinal myoelectric activity disturbance in gastric ulcer disease in rats and dogs. Dig Dis Sci 25:575-580, 1980

    Google Scholar 

  18. Sanders KM, Szurszewsky JH: Doe s endogenous prostaglandin affect gastric antral motility? Am J Physiol 241:G191-G195, 1981

    Google Scholar 

  19. Dooley COP, Mello D, Valenzuela JE: Effects of aspirin and prostaglandin E2 on interdigestive motility complex and duodenogastric reflux in man. Dig Dis Sci 30:513-521, 1985

    Google Scholar 

  20. Schurizek BA, Kraglund K, Andreasen F, Vinter-Jensen L, Juhl B: Antroduodenal motility and gastric emptying. Gastroduodenal motility and pH following ingestion of paracetamol. Aliment Pharmacol Ther 3:93-101, 1989

    Google Scholar 

  21. Bassotti G, Bucaneve G, Betti C, Patoia L, Baratta E, Maresca V, Pelli MA, Morelli A, De l Favero A: Effects of parenteral diclofenac sodium on upper gastrointestinal motility after food in man. Eur J Clin Pharmacol 41:497-500, 1991

    Google Scholar 

  22. Malagelada JR, Azpiroz F, Mearin F: Gastroduodenal motor function in health and disease. In:Gastrointestinal Disease, 5th ed. MH Sleisenger, JS Fordtran (eds). Philadelphia, WB Saunders, 1993, pp 486-508

    Google Scholar 

  23. Mayer EA: The physiology of gastric storage and emptying. In:Physiology of the Gastrointestinal Tract, 3rd ed., LR Johnson (ed). New York, Raven Press, 1994, pp 929-976

    Google Scholar 

  24. Bassotti G, Caste llucci G, Betti C, Fusaro C, Cavalletti ML, Bertotto A, Spinozzi F, Morelli A, Pe lli MA: Abnormal gastrointestinal motility in patients with celiac sprue. Dig Dis Sci 39:1947-1954, 1994

    Google Scholar 

  25. Bassotti G, Stanghellini V, Chiarioni G, Germani U, De Giorgio R, Vantini I, Morlli A, Corinaldesi R: Upper gastrointe stinal motor activity in patients with slow-transit constipation. Further evidence for an enteric neuropathy. Dig Dis Sci 41:1999-2005, 1996

    Google Scholar 

  26. Bassotti G, Be rtotto A, Spinozzi F: Heretical thoughts about food hypersensitivity: Small bowel manome try as an objective way to document gut reactions. Eur J Clin Nutr 51:567-572, 1997

    Google Scholar 

  27. Malagelada JR, Stanghe llini V: Manometric evaluation of functional upper gut symptoms. Gastroenterology 88:1223- 1231, 1985

    Google Scholar 

  28. Malagelada JR, Camilleri M, Stanghe llini V: Manometric Diagnosis of Gastrointestinal MotilityDisorde rs. New York, Thieme, 1986

    Google Scholar 

  29. SAS Institute Inc: SAS/STAT (TM) Guide for personal computer. SAS Institute Inc, Carey, North Carolina, 1987

    Google Scholar 

  30. Roth SH: Non-ste roidal antiinfl ammatory drugs, gastropathy, deaths and medical practice. Ann Intern Med 109:353-354, 1988

    Google Scholar 

  31. Wallace JL: Nonsteroidal antiinfl ammatory drugs and gastroenteropathy: The second hundred years. Gastroenterology 112:1000-1016, 1997

    Google Scholar 

  32. Gustafsson B, Delbro DS: Effects of indomethacin on nonadrenergic, non-cholinergic motility of stomach and small intestine. Eur J Pharmacol 147:67-72, 1988

    Google Scholar 

  33. Gutíé rrez-Cabano CA: Protection against necrotizing age ntsinduced gastric lesions in rats. Unrelated to inhibition of gastric motility. Dig Dis Sci 39:1864-1871, 1994

    Google Scholar 

  34. Brune K, Dietzel K, Numberg B, Schneider H: Recent insight into the me chanism of gastrointestinal tract ulceration. Scand J Rheumatol 16(suppl 65):135-140, 1987

    Google Scholar 

  35. Somasundaram S, Hayllar J, Rafi S, Wriggle sworth J, Macpherson A, Bjarnason I: The biochemical basis of NSAIDinduced damage to the gastrointestinal tract: A review and a hypothesis. Scand J Gastroenterol 30:289-299, 1995

    Google Scholar 

  36. Bjarnason I, Hayllar J: Early pathogenic events in NSAIDinduced gastrointestinal damage. Ital J Gastroenterol 28( suppl 4):19-22, 1996

    Google Scholar 

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Authors
  1. Gabrio Bassotti
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  2. Giampaolo Bucaneve
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  3. Paolo Furno
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  4. Antonio Morelli
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  5. Albano Del Favero
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Bassotti, G., Bucaneve, G., Furno, P. et al. Double-Blind, Placebo-Controlled Study on Effects of Diclofenac Sodium and Indomethacin on Postprandial Gastric Motility in Man. Dig Dis Sci 43, 1172–1176 (1998). https://doi.org/10.1023/A:1018883102636

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  • DOI: https://doi.org/10.1023/A:1018883102636

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