Effect of metoclopramide on the rectosigmoid activity in some systemic diseases

ABSTRACT

The pattern of the recto-sigmoidt myoelectrical activity [MEA] before and after I.V. injection of metoclopramide [0.15 mg/kg] was investigated in normal subjects, in patients with diabetes mellitus [DM], chronic renal failure [CRF], systemic lupus erythematosus [SLE] and scleroderma. In addition, the effect of the drug on patients with autonomic neuropathy [AN] due to DM and CRF was also studied. Furthermore, serum gastrin and plasma vasoactive intestinal polypeptide [VIP] were also estimated in all groups. The present study demonstrated that the pattern of rectosigmoid MEA in DM [Type I and II] and CRF under conservative treatment was not significantly different from that of the normal subjects. One the other hand, in patients with CRF under peritoneal dialysis and in patients with SLE there was a special pattern of MEA characterized by slow waves [SW] composed only of high frequency rhythm [HFR] and could be differentiated from each other by the significantly higher amplitude of the SW in CRF. Conversely, the pattern of MEA in patients with scleroderma was composed only of SW of LER [low frequency rhyhm]. The serum gastrin level was significantly increased in both types of DM and CRF patients while the plasma VIP was significantly increased in type 1 DM, CRF and scleroderma. Metoclopramide has uniform effect in various groups despite the presence or absence of AN. This effect is manifested by significant increase of the LER on the expense of the HER, significant increase in the amplitude of the SW. In patients with SLE and scleroderma, metoclopramide decreased the number of spikes minute. It is concluded that systemic disease can produce a constant and reproducible pattern of rectosigmoid MEA. Metoclopramide produces uniform changes in this MEA regardless of the presence or absence of AN denoting effectiveness of its use in such cases