EFFECT OF MISOPROSTOL ON POSTPRANDIAL INTESTINAL MOTILITY AND OROCECAL TRANSIT-TIME IN HUMANS

We measured the effect of misoprostol (M), a PGE, analog, on duodenoje junal postprandial motor activity and orocecal transit in eight health y volunteers. Intestinal motility was studied by an intraluminal cathe ter with three strain gauge transducers connected to a solid-state dat alogger, and transit time was measured by a hydrogen breath test. Subj ects were studied for two consecutive days and fed twice a day with a similar, 600-kcal meal. Misoprostol (M) at 800, 400, or 200 mug or pla cebo were taken orally before every one of the four meals. Transit tim e was measured after the morning meal on both days, after ingestion of either 800 mug of M or placebo. On four occasions, following M, the n ormal fed pattern was not established and the migrating motor complex (MMC) was not interrupted by the meal. In all other occasions, when th e higher doses of M were given, the first 1-2 hr after the meal reveal ed a hypoactive bowel. This effect was inconsistently seen following 2 00 mug of M. Orocecal transit time was consistently and significantly shorter after M than placebo: 48.3 +/- 9.5 min vs 104.4 +/- 4.8 min, P < 0.0001. Four subjects had diarrhea during the study. We conclude th at misoprostol, particularly at higher doses, has a profound effect on intestinal postprandial motility and results in accelerated transit t ime. The motility changes induced by M may be responsible, in part, fo r its effect on transit.