EFFECTS OF ERYTHROMYCIN IN CHRONIC IDIOPATHIC INTESTINAL PSEUDOOBSTRUCTION

The prokinetic effects of erythromycin, a macrolide antibiotic, on the gastrointestinal tract as a motilin receptor agonist and its potentia l value for the treatment of gastrointestinal motility disorders have recently attracted interest. The effects of erythromycin on the clinic al symptoms and gastrointestinal motility of patients with chronic idi opathic pseudo-obstruction have not been investigated extersively. We presented a case of chronic idiopathic intestinal pseudo-obstruction, in a 67-year-old man in whom oral erythromycin (900 mg/day) dramatical ly improved postprandial abdominal distention, nausea, and vomiting. O ther agents with prokinetic effects on intestinal motility, i.e., cisa pride, domperidone, metoclopramide, and trimebutine maleate did not ha ve a favorable effect. Gastric emptying, measured by the sulfamethizol e method; and intestinal transit, evaluated using radioopaque markers, were markedly improved by treatment with erythromycin. Our experience suggests that the prokinetic effects of erythromycin may be of therap eutic value in chronic idiopathic intestinal pseudoobstruction.