Effect of a Selective 5-HT4 Receptor Partial Agonist Tegaserod on Sensory Function and Compliance of Small Intestine in Humans

Jeong, Jeong Jo; Choi, Myung Gyu; Cho, Yu Kyung; Jun, Eun Jung; Cho, Young Seok; Chung, Woo Chul; Lee, In Seok; Kim, Sang Woo; Choi, Sang Wook; Chung, In Sik

Abstract

BACKGROUND/AIMS
Disturbances in visceral perception contribute to postprandial symptoms in patients with functional dyspepsia. However, the mechanism of perceiving sensation has not been clearly defined. Our aim in this study was to evaluate the effect of tegaserod on compliance and visceral perception in the proximal small intestine.
METHODS
Sixteen healthy subjects were included in this study. Subjects underwent single blinded randomization to either a placebo group or a regimen group of 3-day pretreatment with tegaserod (6 mg bid). Thirty minutes after the insertion of a balloon-equipped, double-lumen tube into the duodenum, we sequentially measured the compliance and maximal tolerable volume to stepwise balloon distension. The maximum volume of the balloon was 120 mL, and an electronic barostat was used to maintain a constant volume within the balloon. Sensory function was assessed by grading accompanying symptoms of nausea, fullness, and abdominal discomfort/pain during random-ordered isovolumetric distension of the balloon at volumes of 20 mL, 40 mL, and 60 mL. We made additional assessments on sensory function by slightly modifying the above method of randomized balloon distension to include continuous infusion of liquid meal into the tube.
RESULTS
There was no significant difference in compliance between the two groups. Maximal tolerable volume was significantly larger in the tegaserod group than in the placebo group (55.7+/-12.9 mL vs. 41.7+/-7.3 mL, p<0.05). Perceived sensations measured using the visual analogue scale during random ordered rapid phasic distension (20, 40, 60 mL) did not reveal differences between the two groups.
CONCLUSIONS
Tegaserod had no effect on perceived sensation during rapid phasic distension, but it did increase the maximal tolerable volume during stepwise distension. These results suggest that tegaserod reduces the sensitivity to small bowel distension in healthy subjects.