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Influence of the pharmacological modification of gastric emptying on lactose digestion and gastrointestinal symptoms
Author(s) -
Katri Peuhkuri,
Heikki Vapaatalo,
Riikka Nevala,
Riitta Korpela
Publication year - 1999
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1999.00450.x
Subject(s) - gastric emptying , lactose , medicine , placebo , metoclopramide , gastroenterology , hydrogen breath test , endocrinology , lactose intolerance , excretion , breath test , stomach , chemistry , biochemistry , vomiting , alternative medicine , pathology , helicobacter pylori
Background: In lactose maldigesters the ingestion of food which retards gastric emptying improves tolerance to lactose. Aim: To study the effects of the pharmacological modification of gastric emptying on the speed of development of lactose‐induced symptoms. Methods: After an overnight fast, 18 lactose maldigesters were given, in a randomized double‐blind study design at 1‐week intervals, either propantheline (as bromide 15 mg), metoclopramide (as hydrochloride 10 mg) or placebo, in identical capsules, 60 min before ingesting 50 g lactose coloured with 1 g carmine dye (to measure gastrointestinal transit time). Gastrointestinal symptoms, urinary galactose excretion, and breath hydrogen and blood glucose concentrations were recorded. Results: The propantheline‐induced prolongation of gastric emptying improved tolerance to lactose, as measured by reduced area under the gastrointestinal symptom score curve 0–12 h, compared to placebo (by 26%) ( P < 0.05) or metoclopramide (by 30%) ( P < 0.05). The total hydrogen excretion AUC (180 min follow‐up) increased by 15% after metoclopra‐ mide as compared with placebo ( P = 0.18). Propantheline decreased this variable by 15% from placebo ( P = 0.17). No significant differences in blood glucose, urinary galactose or gastrointestinal transit time were found. Conclusions: In an oral lactose tolerance test, delaying gastric emptying with propantheline improved tolerance in lactose maldigesters, as measured by diminished gastrointestinal symptoms and reduced breath hydrogen concentration.