Effect of a Single Dose of Oral Erythromycin on Gallbladder Emptying in Normal Subjects

Bae, Young Hwan; Kim, Byung Cheol; Kim, Bok Keun; Lee, Byung Kun; Han, Byung Hoon; Ahn, Su Yul; Lee, Sang Uk; Park, Byung Chae

Abstract

BACKGROUND/AIMS: The correction of gallbladder motility defect might be useful in the prevention and treatment of cbolesterol gallstones. Reciently erythromycin has been known to have motilin like effect on the motility of gastrointestinal tract and the galbladder. Therefore we examined whether and to what extent the oral administration of erythromycin combination with a test meal is able to improve gallbladder emptying in normal population by means of real time ultrasonography.
METHODS
Seventeen healthy volunteers(fifteen men and two women) with a mean(range) age of 28.5(26-31) years were examined by a real time ultrasonogram(Aloka Echo Camera SSD-650, 3.5-MHz transducer). Gallbladder volume was determined after 12 hours fasting, and again 30, 60, 90, 120 and 180 min after beginning the test meal that contained 700 Cal - 55% as carbohydrate, 27% as protein, and the rest as fat. One week later, gallbladder volume was rechecked with the same way as previously after administration of erythromycin at the dose of 500 mg orally 30 min before serving test meal in the same subjects.
RESULTS
Fasting gallbladder volume was 19.2 3.3 rnl. Minimal residua] volume, and minimal residual volume % were slightly lower in the procedure of test meal with erythromycin(2.1+0.7 ml, 11.2+4.3%) than in the procedure of test meal only(2.9 1.5 tnl, 14.9+7.7%). The time reaching at the minimal residual volume was shorter m the procedure of test meal with erythromycin(104.1 15.0 min) than in the procedure of test meal only(111.2+13.7 min), but these differences were not significant statistically. Residual volume % was lower in the procedure of test meal with erythromycin than in the procedure of test meal only at 30 min(32.9+7.0% vs 50.9+14.3%, respectively, p=0.0001), 60 rnin(18.7 5.1% vs 30.411.1%, p=0.0012), and 90 min(13.9+ 5.4% vs 19.7L-12.8%, respectively, p=0.0357) signi- ficantly, but it showed negligible difference at 120 min(12.9+6.3% v 15.7+7.6%), and no difference at 180 min(39.6+21.8% vs 39.7 14.4%) between these two procedures.
CONCLUSIONS
Erythromycin showed negligible effect on lowering minimal residual volurne, minimal residual volume %, and the time reaching at the minimal residual volurne simingly, but showed strong effect on gallbladder emptying at 30 minutes, 60 minutes and 90 minutes after test meal.