A comparative study of esophageal and anorectal motility in myotonic dystrophy.

Myotonic dystrophy may be associated with visceral abnormalities involving smooth muscle, the pathogenesis of which is not clear. Our aim was to evaluate the involvement of smooth and striated muscles at both ends of the gastrointestinal tract. Esophageal and anorectal manometric studies were performed in 13 patients and healthy controls. There was a correlation between: (1) the resting pressure in the upper esophageal sphincter and in the lower anal canal, (2) the amplitude and the coordination of contraction primary waves in the proximal and in the distal esophagus, and (3) the resting pressure in the higher anal canal and in the lower one. These results suggest that both ends of the gastrointestinal tract are disturbed in a similar fashion, both quantitatively and qualitatively and that there is a relationship between smooth and striated visceral muscle involvement in myotonic dystrophy.

Colonic transit in soccer players.

To evaluate the effects of exercise on colonic function, we measured total and segmental transit times in 11 male soccer players and nine male radiology student technicians. Diet was kept constant in all subjects, who maintained their normal activities. For the soccer players, normal activities included 15 h of training and one match each week. Transit times were measured with radioopaque markers, using the multiple-ingestion, single-radiograph technique. No overall difference in large bowel transit was observed between the two groups. Right colon transit was considerably slower in the soccer players, whereas left colon and rectal transit were slightly accelerated. We conclude that an intensive sport activity only modifies regional differences in large bowel function. This may be of importance in extreme conditions, such as those experienced by marathon runners. Data should be obtained before prescribing exercise to treat constipation.

[The effect of ranitidine on gastric pH measured by continuous monitoring over 24 hours in healthy subjects. Comparison of 2 methods of administration: 150 mg morning and night, vs 300 mg in a single dose at night]. / Effet de la ranitidine sur le pH gastrique mesuré par enregistrement continu sur 24 heures chez le sujet sain. Comparaison de deux modes de fractionnement: 150 mg matin et soir, vs 300 mg en prise unique le soir.

The gastric pH of 8 healthy subjects was determined, in a continuous fashion, during three different 24 hour periods corresponding to the 3 following treatments: Placebo, ranitidine 150 mg twice per day, and ranitidine 300 mg in the evening. During each period, the feeding conditions were normal and standardized. The results are expressed in terms of the number of hours under a threshold pH value. In comparison with the placebo, ranitidine, regardless of its mode of administration, results in a significant decrease of the mean number of hours under pH 1.5, 2 and 3 during 24 hours; no significant difference was demonstrated between the two modes of administration in 24 hours. During the 12 night-hours, a single dose of 300 mg of ranitidine was more effective to ranitidine taken in 2 doses for pH thresholds of 2 and 3, while during the 12 day-hours, no difference was demonstrated for pH thresholds of 1.5, 2 and 3. The analysis of the mean pH graphs in relation to time, suggests that a single 300 mg dose is more effective than the same dose divided into 2 doses during the day. These results tally with the variations of ranitidine plasma levels in 24 hours. These results justify, from a pharmacological standpoint, the prescription of a single dose of ranitidine, in the evening.

Effects of roxatidine acetate on 24-hour gastric acidity. Early evening versus bedtime administration in healthy subjects.

The gastric antisecretory activity of roxatidine acetate was studied on 24-hour intragastric pH in 12 healthy male volunteers. The study was randomised, double-blind and double-dummy where either roxatidine acetate 150 mg as a slow release granulated formulation or placebo were administered at 7.30 pm or 10 pm. Roxatidine acetate 150 mg produced a significant decrease in the number of hours during which gastric acidity ranged between pH 1.5 and 4.0 which was consistent with the pharmacokinetic profile of the drug. There was no significant difference between the median intragastric pH values for early evening and bedtime administration of roxatidine acetate. The present data confirm that roxatidine acetate 150 mg inhibits gastric acid secretion but while a single evening dose is effective in controlling intragastric pH the results suggest there is no clear advantage in an early evening dose compared with a bedtime dose.

[Behavior of the patient with functional colon disease: types, analytical methods and therapeutic significance]. / Le comportement du colopathe fonctionnel: richesse, modes d'analyse et intérêt thérapeutique.

A proper clinical examination should provide psychological data that enriches the patient-physician relationship. Video recording and its analysis do not disturb the patient and provide for objective awareness. This technique confirms the idea that the behaviour and psychological structure of the colopath fall into two major and basic types: compulsive obsessionals and hysterophobics, types that should lead the practitioner to provide different sorts of psychological care. This care can form the basis for the treatment of the colopath.