Erythromycin improves gastric emptying half-time in adult cystic fibrosis patients with gastroparesis

Abstract Background Gastrointestinal manifestations are frequently encountered in cystic fibrosis patients. Gastroparesis evidenced by a variety of diagnostic methods has been described in patients with cystic fibrosis, predominantly in children and in individuals with advanced lung disease. The pre...

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Published in:	Journal of cystic fibrosis Vol. 8; no. 3; pp. 193 - 197
Main Authors:	Tonelli, Adriano R, Drane, Walter E, Collins, Dennis P, Nichols, Wanda, Antony, Veena B, Olson, Eric L
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 01-05-2009
Subjects:	Adult Cystic fibrosis Cystic Fibrosis - complications Cystic Fibrosis - diagnostic imaging Erythromycin Erythromycin - administration & dosage Female Gastric Emptying - drug effects Gastric emptying scintigraphy Gastrointestinal Agents - administration & dosage Gastroparesis Gastroparesis - complications Gastroparesis - diagnostic imaging Gastroparesis - drug therapy Humans Male Pulmonary/Respiratory Radionuclide Imaging Retrospective Studies Technetium Treatment Outcome Young Adult Cystic fibrosis Gastric emptying scintigraphy Erythromycin Gastroparesis
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Summary:	Abstract Background Gastrointestinal manifestations are frequently encountered in cystic fibrosis patients. Gastroparesis evidenced by a variety of diagnostic methods has been described in patients with cystic fibrosis, predominantly in children and in individuals with advanced lung disease. The presence of gastroparesis in adult patients with different degrees of lung involvement and its response to the acute and chronic administration of macrolides have not been reported. Methods Using the University of Florida Cystic Fibrosis database we identified symptomatic patients who had gastroparesis confirmed by a prolonged half-time during gastric emptying scintigraphy. Results Of 86 cystic fibrosis patients, periodically followed in our institution, we found five who had classical symptoms and prolonged gastric emptying half-time. Age 25.2 ± 8 years, 80% females, BMI 22 ± 9 kg/m2 , HbA1c 5.8 ± 0.6 g/dl, FEV1 53.2 ± 15% of predicted. Gastric emptying half-time was 191.4 ± 91.4 min (range 100–300 min) and decreased to 12.2 ± 6 min (range 5–20 min) after IV administration of erythromycin ( p = 0.043). Patients were followed up for 3 ± 2.1 years. All patients but one, who was taking opiods, had good clinical response to PO macrolides. Conclusions Gastroparesis occurs in patients with cystic fibrosis, even in patients with relatively preserved lung function and in those without cystic-fibrosis related diabetes. Macrolides may be an effective therapy in cystic fibrosis patients with gastroparesis when administered acutely or chronically.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1569-1993 1873-5010
DOI:	10.1016/j.jcf.2009.02.001