ABSTRACT
La prucaloprida acelera el vaciamiento gástrico en adultos con gastroparesia. No existen estudios con este medicamento en niños con gastroparesia. Se presenta un niño de 8 años que consultó por síntomas posprandiales de un mes de duración, con diagnóstico de gastroparesia por gammagrafía de vaciamiento gástrico. No mejoró con metoclopramida, domperidona, eritromicina y esomeprazol. Recibió prucaloprida durante dos períodos (durante 178 y 376 días) a dosis de 0,03-0,04 mg/kg/día. Presentó mejoría en el seguimiento con el índice cardinal de síntomas de gastroparesia y gammagrafías de vaciamiento gástrico. Por la buena respuesta, la prucaloprida podría ser una opción terapéutica en la gastroparesia pediátrica.
Prucalopride has been used in adults with gastroparesis, accelerating gastric emptying. There are no studies with this drug in gastroparetic children. An 8-year-old boy is presented who consulted for a month of postprandial symptoms, with a diagnosis of gastroparesis by gastric emptying scintigraphy. He did not improve with metoclopramide, domperidone, erythromycin, and esomeprazole. He received prucalopride for two periods (for 178 and 376 days) at doses: 0.03 - 0.04 mg/kg/day, presenting improvement in the follow-up with the cardinal gastroparesis symptom index and gastric emptying scintigraphy. Due to the good response, prucalopride may be a therapeutic option in pediatric gastroparesis.
Subject(s)
Humans , Male , Child , Benzofurans/therapeutic use , Gastroparesis/diagnosis , Gastroparesis/drug therapy , Domperidone/therapeutic use , Gastric EmptyingABSTRACT
Abstract The universal definition of myocardial infarction (MI) provides five subtypes of acute myocardial infarction (AMI). We present an interesting case of a type 2 myocardial infarction caused by the dilation of the left thoracic stomach.
Subject(s)
Humans , Male , Aged , Stomach/surgery , Gastric Dilatation/etiology , Anastomosis, Surgical/adverse effects , Esophagus/surgery , Inferior Wall Myocardial Infarction/etiology , Gastric Dilatation/drug therapy , Gastric Dilatation/diagnostic imaging , Benzamides/therapeutic use , Gastrointestinal Agents/therapeutic use , Morpholines/therapeutic use , Acute Disease , Esophagectomy/methods , Gastroparesis/etiology , Gastroparesis/drug therapy , Gastroparesis/diagnostic imaging , Coronary Stenosis/etiology , Coronary Stenosis/drug therapy , Coronary Stenosis/diagnostic imaging , Electrocardiography , Esophagus/diagnostic imaging , Inferior Wall Myocardial Infarction/diagnosisSubject(s)
Humans , Female , Adult , Young Adult , Heart Arrest , Metoclopramide/adverse effects , Drug Prescriptions , Gastroparesis/drug therapySubject(s)
Humans , Cisapride/pharmacology , Erythromycin/pharmacology , Constipation/drug therapy , Diabetes Mellitus/complications , Domperidone/therapeutic use , Gastroparesis/drug therapy , Renal Insufficiency, Chronic/complications , Metoclopramide/therapeutic use , Intestinal Pseudo-Obstruction/drug therapyABSTRACT
AIMS: Diabetic gastroparesis is a common complication seen in 20-50% of patients due to autonomic neuropathy involving vagal supply. Cisapride, a specific gastrointestinal cholinomimetic agent may thus be effective. METHODS: Fifty-one diabetic patients (age 12-65 years) of disease duration > 5 years were assessed for symptomatic gastroparesis, other diabetic complications and glycemic control. Gastric emptying time (GET) was estimated using a solid meal method (99mTc labeled rice based idli) and patients randomized to receive either cisapride or placebo for a period of 2 weeks. Cisapride was administered in a dose of 10 mg TID. GET and symptom scores were reassessed on the therapy after 2 weeks. RESULTS: Twenty nine of 51 (56.8%) patients had gastroparesis. Mean GET in the gastroparesis group was 141 +/- 66 minutes compared to 24.53 +/- 10 minutes in the non gastroparesis group (p < 0.01). GET decreased by 72% amongst the patients who received cisapride compared to 23% in the placebo group (p < 0.001). Symptom scores also improved in the cisapride group; no adverse effects were noted. CONCLUSIONS: Cisapride improves the symptom score and the solid gastric emptying time in patients suffering from diabetic gastroparesis.
Subject(s)
Adolescent , Adult , Aged , Child , Cisapride/therapeutic use , Diabetic Neuropathies/complications , Double-Blind Method , Gastric Emptying/drug effects , Gastrointestinal Agents/therapeutic use , Gastroparesis/drug therapy , Humans , Middle AgedABSTRACT
La eritromicina, un antibiótico del grupo de los macrólidos, ha demostrado recientemente que tiene un efecto similar a la motilina sobre la fibra muscular gastrointestinal. Mostramos nuestra experiencia en 4 casos de tratamiento exitoso de la gastroparesia postoperatoria con eritromicina oral. Todos eran de sexo masculino (rango 30-81, media 54 años de edad) y 3 de ellos habian sido sometidos a una cirugía gástrica. Una grave gastroparesia apareció después de la cirugía por lo que la aspiración nasogástrica no pudo retirarse, aunque los pacientes fueron tratados con domperidona. cisaprida y corrección de su balance hidroeléctrico y de su condición nutritiva. Recibieron 500 mg de eritromicina cada 6-8 h lo que dramáticamente aceleró el vaciamiento gástrico y un día después del tratamiento los pacientes se encontrabam completamente recuperados de la gastroparesia