Gastroparesis is a disorder in which the stomach muscle loses its motility and function to pass food from the stomach into the digestive system. There are many causes for gastroparesis, including viral and bacterial illnesses, hypothyroidsim and sclerdoma. The symptoms of gastroparesis are commonly described as a heavy, fullness of the stomach, nausea, heartburn and vomiting. The most common cause of gastroparesis is diabetes. Treatments vary but include the use of a commonly prescribed antibiotic, erythromycin.
Erythromycin is an anti-infective used to treat a variety of disease states such as bacterial endocarditits, gastroenteritis, chancroid, pneumonia, lymphogranuloma venereum, mycoplasma, ear infections, pharyngitis, skin or soft tissue Infection, syphilis, upper respiratory tract infection, bronchitis, chlamydia infection, lyme disease, and for prevention rheumatic fever. It does not list gastroparesis as a indicated condition. Reglan (metocloparmide) is the only drug approved by the Food and Drug Adminsitration for gastroparesis treatment.
The Mylan School of Pharmacy at Duquesne University in Pittsburgh, PA posted the question regarding erythromycin efficacy in the treatment of gastroparesis, which includes cases caused by diabetes. They state that this drug has been used for years to treat gastroparesis because it increases motility by stimulating receptors in the stomach that increase the muscular contractions that move the food from the stomach into the digestive tract.
Dosage for Gastroparesis
Dosage has ranged from 50-250 mg three times daily, normally taken 30 minutes before meals. According to the University of Utah School of Medicine, IV erythromycin works better at increasing stomach emptying. In a study performed by the University, one group of diabetic patients were given 250mg of erythromycin and the other group received 1000mg. The study showed no difference in effectiveness between the doses.
According to Drugs.com, this medication has relatively little side effects; however, those reported include nausea, abdominal pain, diarrhoea, and vomiting, rash, fever, arrhythmias and hypotension (low blood pressure) following intravenous administration and recurrent nightmares.
Serious side effects that may indicate an allergic reaction include rash, including hives or itching, breathing difficulties, chest pressure or tightness, swelling of the mouth, face, lips, or tongue, bloody stools, changes in hearing, irregular heartbeat, muscle weakness, red, swollen, or blistered skin, severe diarrhoea, severe stomach pain or cramps and yellowing of the skin or eyes.
A study posted by the Mylan School of Pharmacy regarding 50-100 mg of erythromycin 15-30 minutes prior to eating with the addition of a low-bulk diet provided short term relief of symptoms in the majority of patients, but the relief was often short lived. Their conclusion was that though erythromycin has been commonly used for gastroparesis, there is very little evidence of its effectiveness for gastroparesis treatment.
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