EFFECT OF DIFFERENT DOSES OF ERYTHROMYCIN ON COLONIC MOTILITY IN PATIENTS WITH SLOW TRANSIT CONSTIPATION

Background: Erythromycin has been proposed as a therapeutic agent for the treatment of functional motor disorders of the upper gastrointesti nal tract. Moreover, some data exist showing a potential effect on col onic motility. Aims: Since no data are available concerning erythromyc in effects in chronically constipated : patients, we investigated the effects of three different doses of the drug (50, 200, and 500 mg i. v .) on colonic intraluminal pressures in such patients. Patients and me thods: 18 severely constipated women were studied by a colonoscopicall y-positioned manometric probe, and were randomized to receive one of t hree doses of erythromycin. Proximal and distal colonic motility was r ecorded basally, then during placebo infusion for 60 min and for a fur ther 60 min after the drug had been infused. Results: Analysis of the tracings showed that. except for the lowest dose in the distal colon, erythromycin failed to stimulate colonic motility in constipated patie nts. Conclusions: It is concluded that erythromycin cannot be consider ed a colokinetic agent, at least at doses commonly employed in the upp er gut.