EFFECT OF ERYTHROMYCIN ADMINISTRATION ON UPPER GASTROINTESTINAL MOTILITY IN SCLERODERMA PATIENTS

Background: Gastrointestinal involvement is frequent in patients with scleroderma. Erythromycin, a macrolide antibiotic, has been shown to a ccelerate gastric emptying in normal subjects and diabetic patients. T he present study investigated the effects of acute erythromycin admini stration on gastric and gallbladder motility in patients with sclerode rma and gastrointestinal involvement. Methods: Twelve scleroderma pati ents and 14 healthy subjects were investigated. Each subject was inves tigated on 4 different days. Gastric and gallbladder emptying and gast ric motility were determined by sonography and manometry, and the effe ct of 2 mg/kg/h erythromycin in fasted patients or after semisolid mea l evaluated. Results: The half-time of gastric emptying in response to semisolid meal was 121.3 +/- 14.0 min (SE) in scleroderma patients an d 45.7 +/- 10.4 min in healthy subjects (P < 0.01). The peak of gallbl adder emptying occurred later in scleroderma patients (95.0 +/- 5.0 mi n) than in healthy subjects (45.0 +/- 8.0 min) (P < 0.01). Erythromyci n stimulated gastric and gallbladder motility in fasted subjects, as s hown by manometry and sonography, and accelerated gastric and gallblad der emptying when administered immediately before the meal (P < 0.01). Conclusions: Erythromycin accelerates gastric and gallbladder emptyin g in scleroderma patients and might be helpful in the treatment of gas trointestinal motor abnormalities in these patients.