TREATMENT OF GASTROPARESIS, CAUSED BY RAD IOTHERAPY, WITH ERYTHROMYCIN

History: A 75-year-old woman who had undergone a hysterectomy with adn exectomy followed by radiotherapy for endometrial carcinoma complained of postprandial nausea with vomiting after eating solid foods and of cramp-like abdominal pain, but her appetite was good. She had lost 25 kg in weight over 13 months. Examination: Physical examination, labora tory tests, radiology and gastroscopy were unremarkable. Gastric scint igraphy showed abnormally prolonged emptying.Treatment and course: Nau sea and vomiting stopped at once after erythromycin (a motilin agonist ) had been administered. It was at first given intravenously after mea ls (50 mg three times daily for 5 days), then orally for 10 weeks (250 mg three times daily before meals). Subsequent examination revealed n ormal gastric emptying. The symptoms did not recur after erythromycin had been discontinued. Conclusion: Erythromycin is an effective drug a gainst gastroparesis caused by radiotherapy, because it acts even when the enteric nerves are damaged.