Effect of gastric volume or emptying on meal-related symptoms after liquid nutrients in obesity: A pharmacologic study

Silvia Delgado-Aros, Michael Camilleri, E. Janet Castillo, Filippo Cremonini, Debra Stephens, Irene Ferber, Kari Baxter, Duane Burton, Alan R. Zinsmeister

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

Background & Aims: Altered postprandial satiation influences food intake in obesity. The aim of this study was to evaluate the contribution of gastric motor functions to intra- and postprandial symptoms in obese, otherwise healthy, people. Methods: In a randomized, parallel-group, double-blind design, 40 obese (body mass index > 30 kg/m2) healthy volunteers (n = 10/group) received intravenous saline (placebo), atropine (.02 mg/kg), or erythromycin (1 or 3 mg/kg) to alter gastric volume and emptying after liquid nutrient meals, measured by validated imaging methods. The nutrient drink test assessed the volume ingested at maximum satiation, and intra- and early postprandial symptoms. Relationships between gastric motor functions, meal size, and symptoms were assessed by using multiple regression. Circulating levels of candidate upper-gut hormones involved in satiation were measured. Results: Relative to placebo, atropine retarded gastric emptying and increased gastric volumes; erythromycin accelerated gastric emptying and reduced gastric volumes during fasting. Although similar maximal tolerated volumes were recorded across treatments, intra- and immediate postprandial symptoms were increased by these perturbations, particularly nausea and bloating. Upper-gut hormonal profiles generally reflected changes in gastric emptying. Regression analysis showed that fasting predrug gastric volume was a significant predictor of intra- and postprandial bloating. Change in gastric volume postdrug or postmeal did not contribute additionally to predicting intra- or postprandial symptoms. There was significant (negative) association between gastric emptying and fullness score, and significant (positive) association with hunger score 30 minutes postprandially. Conclusions: In obese individuals, fasting gastric volumes and gastric emptying, but not postprandial gastric volumes, were associated with intra- and postprandial symptoms. Understanding the determinants of gastric volume may provide insights on mechanisms controlling satiation.

Original languageEnglish (US)
Pages (from-to)997-1006
Number of pages10
JournalClinical Gastroenterology and Hepatology
Volume3
Issue number10
DOIs
StatePublished - Oct 1 2005

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Delgado-Aros, S., Camilleri, M., Castillo, E. J., Cremonini, F., Stephens, D., Ferber, I., Baxter, K., Burton, D., & Zinsmeister, A. R. (2005). Effect of gastric volume or emptying on meal-related symptoms after liquid nutrients in obesity: A pharmacologic study. Clinical Gastroenterology and Hepatology, 3(10), 997-1006. https://doi.org/10.1016/S1542-3565(05)00285-5