piperidines and Malabsorption-Syndromes

We have investigated the fasting and postprandial patterns of gastrointestinal pressure activity in a group of patients with extensive (greater than 100 cm) resections of the distal small bowel. Each short bowel patient was studied on 2 consecutive days with random single blind administration of either loperamide (6 mg at 5 h and at 30 min before the meal) or placebo, and 20 healthy controls were studied on single days (13 basal fasting, 7 placebo). During fasting, the duration of the interdigestive motor complex was significantly shorter in patients with short bowel syndrome (71.1 +/- 15.6 min vs. 109 +/- 7.8 min for controls, p less than 0.03); hence, the frequency of complexes was increased. The duration of phase 2 was strikingly shorter in patients (18.7 +/- 7.0 min vs. 52.9 +/- 8.5 min for controls, p less than 0.03). Gastric emptying and postprandial motor activity were identical in patients and controls. During fasting, loperamide prolonged phase 3 (7.6 +/- 2.2 min vs. 4.3 +/- 1.1 min for placebo, p less than 0.03). Postprandially, loperamide shortened the time from meal ingestion to the first phase 3 by 50% (p less than 0.003), and increased motility index and frequency of contraction in the gut (p less than 0.01). Thus, gut motor activity in the short bowel syndrome is characterized by more frequent interdigestive motor complexes, marked reduction in phase 2 activity, and a normal feeding pattern. Loperamide therapy increases feeding activity while at the same time shortening its duration.

Topics: Adult; Aged; Eating; Fasting; Female; Gastrointestinal Motility; Humans; Loperamide; Malabsorption Syndromes; Male; Middle Aged; Motor Neurons; Piperidines; Pressure; Short Bowel Syndrome; Time Factors

Topics: Cisapride; Humans; Infant; Jejunum; Malabsorption Syndromes; Piperidines; Short Bowel Syndrome

Patients with the short bowel syndrome are usually afflicted by chronic diarrhoea and treated with opiate drugs, yet little documentation of the effects of such drugs on digestive function is available. In the present study we found that acute oral administration of loperamide resulted in 50% inhibition of postprandial trypsin and bilirubin output in patients with short bowel syndrome. These changes are consistent with an opiate effect.

Topics: Adult; Aged; Bile; Bilirubin; Depression, Chemical; Female; Food; Humans; Loperamide; Malabsorption Syndromes; Male; Middle Aged; Pancreas; Piperidines; Short Bowel Syndrome; Trypsin

Topics: Amines; Anaerobiosis; Animals; Bacteria; Bile Acids and Salts; Blind Loop Syndrome; Celiac Disease; Female; Growth; Hippurates; Indican; Indoleacetic Acids; Intestine, Small; Lincomycin; Malabsorption Syndromes; Neomycin; Phenols; Piperidines; Proteins; Pyrrolidines; Rats

Topics: Amino Acids; Animals; Blind Loop Syndrome; Hippurates; Intestine, Small; Malabsorption Syndromes; Nitrogen; Phenols; Piperidines; Pyrrolidines; Rats

Topics: Digestive System Abnormalities; Duodenum; Esophagus; Female; Gastrointestinal Motility; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Absorption; Intestinal Obstruction; Malabsorption Syndromes; Male; Megacolon; Piperidines; Postoperative Complications