Background/aims: Gallbladder emptying abnormalities are common in patients with diabetes mellitus, and it has been hypothesized that they contribute to the increased incidence of gallbladder stones and biliary pain observed in these patients. Cisapride is a drug that exerts a prokinetic effect in both animals and humans. Recently, we demonstrated that cisapride decreased the fasting and post-prandial gallbladder volume in healthy subjects. Therefore, we investigated the action of cisapride on gallbladder contraction in diabetic patients.
Methodology: Twenty diabetes mellitus patients and 20 healthy volunteers participated in this study. On the day of the study, ultrasonography was performed at 9 am, after 12 hours of fasting. After the basal measurement was obtained, the diabetic patients and healthy subjects received 10 mg cisapride or a placebo peroral. Two hours later, gallbladder volumes were rescanned by ultrasonography at 15-minute intervals for 60 minutes.
Results: The fasting gallbladder volume was 19.8 +/- 6.7 ml in the diabetic patients, and after the administration of cisapride, the gallbladder volume decreased by 32.2%-38.6% as compared to the baseline (p<0.02, 0.05, 0.01) and by 35.0%-45.8% as compared to the diabetic controls (p<0.02, 0.05, 0.001). In the healthy subjects, cisapride did not change the fasting mean gallbladder volume as compared to the baseline. After the administration of cisapride in the diabetic patients, the mean gallbladder volume decreased more than in the healthy subjects. The mean gallbladder volumes of the diabetic patients were between 12.1 +/- 4.2-13.4 +/- 4.2 ml. In the healthy volunteers, after the administration of cisapride, the volume was reduced by 1.9%-11.3% as compared to the healthy control group, but the volume changes of these two groups were not statistically significant.
Conclusion: This study shows that the administration of cisapride causes gallbladder volume reduction in diabetic patients.
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Dig Dis Sci
August 2004
Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India.
The role of female sex hormones in the pathogenesis of gallstones is well established. Pregnancy, contraceptive use, estrogen replacement therapy in postmenopausal women, and estrogen therapy in men for the treatment of prostatic carcinoma have been found to be associated with increased risk of cholesterol gallstones. Alterations in gallbladder emptying and in bile lithogenicity in postmenopausal women receiving hormone replacement therapy (HRT) have not been studied to date.
View Article and Find Full Text PDFDig Liver Dis
July 2003
Department of Medicine and Ageing, G. d'Annunzio University, Chieti-Pescara, Italy.
Various drugs and medications that inhibit or stimulate gallbladder contraction and basal tone in humans are described. Active gallbladder contraction may be achieved using synthetic hormones such as cholecystokinin, caerulein and motilin, cholinomimetic drugs such as bethanecol, prostigmine, and erythromycin due to its motilin-like effect. Furthermore, cisapride and cholestyramine, may have some excitatory activity on the gallbladder muscle.
View Article and Find Full Text PDFWe examined 74 patients at the age of 18-54 with a chronic bilary pathology, including 50 patients with chronic non-calculous cholecystitis, 16 patients with a gallbladder dysfunction, and 8 patients with cholelithiasis. The differentiated correction of the motor gallbladder dysfunction can be carried out on the basis of the analysis of heart rate variability parameters and results of the gallbladder dynamic sorbite echography against the background of the action of vegetotropic pharmacological preparations (Atropine, Propranolol, Metoclopramide, Hymecromone, Cisapride, Amitriptyline).
View Article and Find Full Text PDFAliment Pharmacol Ther
February 2003
Division of Gastroenterology, Kliniken St. Antonius, Wuppertal, Germany.
Background: Although peppermint oil and caraway oil are frequently used in herbal drugs for abdominal discomfort and pain, the pharmacological insights into their effects on the gastrointestinal tract are poor.
Methods: The pharmacodynamic effects of 90 mg peppermint oil (WS 1340) and 50 mg caraway oil (WS 1520) on the motility of the stomach and gall-bladder, and on the orocaecal transit time, in comparison with placebo, 10 mg cisapride and 10 mg n-butylscopolamine, were studied in 12 healthy volunteers. The study involved simultaneous ultrasonic determination of gastric and gall-bladder emptying, together with assessment of the orocaecal transit time using the lactulose H2 breath test.
Am J Physiol Gastrointest Liver Physiol
March 2003
Department of Anatomy and Neurobiology, The University of Vermont, Burlington, VT 05405, USA.
The current study was undertaken to test the existence and possible role of ether-a-go-go-related gene 1 (ERG1) protein K(+) channels in gallbladder smooth muscle (GBSM). Transcripts encoding ERG1 were detected in human, mouse, and guinea pig GBSM, and ERG1 immunoreactivity was observed in GBSM cells. In intracellular voltage recordings, addition of E-4031 (100 nM-1 microM) or cisapride (100 nM-2 microM) caused concentration-dependent excitation of guinea pig GBSM that was not affected by 500 nM TTX + 5 microM atropine, and E-4031 also depolarized the resting membrane potential.
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