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Effect of alosetron on left colonic motility in non‐constipated patients with irritable bowel syndrome and healthy volunteers
Author(s) -
Clemens C. H. M.,
Samsom M.,
Van Berge Henegouwen G. P.,
Fabri M.,
Smout A. J. P. M.
Publication year - 2002
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.1365-2036.2002.01252.x
Subject(s) - medicine , irritable bowel syndrome , gastroenterology , placebo , motility , pathology , alternative medicine , biology , genetics
Background: Alosetron is a 5‐hydroxytryptamine‐3 receptor antagonist reducing symptoms in female patients with diarrhoea‐predominant irritable bowel syndrome, and is known to increase the colonic transit time. Aim: To study the effect of alosetron on left colonic phasic motility in ambulant non‐constipated patients with irritable bowel syndrome and healthy volunteers. Methods: In a double‐blind, randomized, crossover design, 10 patients with irritable bowel syndrome and 12 sex‐ and age‐matched volunteers were treated for two 7‐day periods with alosetron, 4 mg b.d., or placebo b.d. On day 6 of each treatment period, a six‐channel solid‐state manometric catheter was positioned in the left colon and 24 h motility was studied on day 7. The periprandial phasic motility around dinnertime was evaluated in the descending and sigmoid colon. The high‐amplitude propagated contraction frequency and characteristics were calculated. Results: Alosetron appeared to increase the overall periprandial frequency in the sigmoid colon ( P =0.043) and the mean amplitude of colonic contractions in the descending colon ( P =0.007). The high‐amplitude propagated contraction frequency was higher on alosetron during the second half of the day for patients with irritable bowel syndrome ( P =0.002), with increased mean propagation length of high‐amplitude propagated contractions ( P =0.001). The stool frequency ( P =0.024) and stool consistency score ( P =0.002) were decreased by alosetron. Conclusions: The 5‐hydroxytryptamine‐3 receptor antagonist alosetron marginally increased left colonic periprandial phasic motility. Alosetron increased the number and propagation length of high‐amplitude propagated contractions, which were paradoxically accompanied by a decrease in stool frequency and a firming of stool consistency.