Omeprazole on an empty stomach
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Effects of Omeprazole on Gastric Emptying When Taken on an Empty Stomach
Introduction to Omeprazole and Gastric Emptying
Omeprazole, a proton pump inhibitor (PPI), is commonly used to treat conditions like gastroesophageal reflux disease (GERD) and peptic ulcers by reducing stomach acid production. However, its impact on gastric emptying, particularly when taken on an empty stomach, has been a subject of various studies. This article synthesizes findings from multiple research papers to provide a comprehensive understanding of how omeprazole affects gastric emptying.
Omeprazole and Gastric Emptying Rates
General Effects on Gastric Emptying
Several studies have consistently shown that omeprazole delays gastric emptying. For instance, a double-blind placebo-controlled trial found that omeprazole significantly slowed the emptying rate of solid meals, although it had no effect on liquid emptying or the lag phase of solids1. Another study confirmed these findings, showing that pretreatment with omeprazole reduced the gastric emptying rates of both liquid and solid meals2.
Specific Findings in Healthy Subjects
In healthy volunteers, omeprazole has been shown to delay the gastric emptying of digestible solid meals. One study demonstrated that omeprazole treatment resulted in a significant delay in gastric emptying, as evidenced by greater residual distension of the antrum throughout the study period7. Another study using a dual isotope scintigraphic technique found no significant effect on solid or liquid gastric emptying in patients with duodenal ulcer disease, suggesting that the impact of omeprazole may vary based on the health status of the individual6.
Mechanisms Behind Delayed Gastric Emptying
Hormonal Influences
The delay in gastric emptying induced by omeprazole may be related to changes in gut hormone secretion. One study found that omeprazole treatment led to higher plasma gastrin concentrations and a significant decrease in cholecystokinin (CCK) release, which could contribute to the delayed gastric emptying observed2. Additionally, the study noted a direct relationship between the amounts of liquid emptied and plasma motilin concentrations, further implicating hormonal changes in the delayed gastric emptying effect.
Gastric Myoelectrical Activity
Omeprazole also appears to influence gastric myoelectrical activity. A study investigating the effects of omeprazole on gastric motility found that while omeprazole did not significantly alter gastric emptying parameters, it did improve gastric myoelectrical activity, which may help alleviate dyspeptic symptoms in functional dyspepsia patients9.
Clinical Implications and Considerations
Potential for Dyspeptic Symptoms
The delay in gastric emptying caused by omeprazole can lead to dyspeptic symptoms in some individuals. This is particularly relevant for patients with functional dyspepsia or other gastrointestinal disorders where delayed gastric emptying can exacerbate symptoms8.
Interaction with Other Medications
Interestingly, the delayed gastric emptying effect of omeprazole can be countered by co-treatment with promotility agents like tegaserod. Studies in both humans and mice have shown that tegaserod can prevent the slowing effect of omeprazole on gastric and small intestinal transit, suggesting a potential therapeutic strategy for managing omeprazole-induced dyspeptic symptoms5 8.
Conclusion
Omeprazole, when taken on an empty stomach, generally delays gastric emptying, particularly for solid meals. This effect is mediated through changes in gut hormone secretion and alterations in gastric myoelectrical activity. While this delay can lead to dyspeptic symptoms, co-treatment with promotility agents like tegaserod may offer relief. Understanding these effects is crucial for optimizing the therapeutic use of omeprazole and managing potential side effects.
Sources and full results
Most relevant research papers on this topic
Short report: a double‐blind placebo‐controlled trial of omeprazole on characteristics of gastric emptying in healthy subjects
Omeprazole does not affect liquid or solid gastric emptying characteristics, but decreases the emptying rate of solids in healthy subjects.
RCTA double-blind placebo-controlled study on the effects of omeprazole on gut hormone secretion and gastric emptying rate.
Pretreatment with 40 mg omeprazole daily decreases gastric emptying rates and significantly influences gut hormone secretion, potentially impacting clinical outcomes.
RCTEffect of Omeprazole on Gastric Emptying in Patients with a History of Duodenal Ulceration
A single oral dose of omeprazole, 90 mg, effectively delays gastric emptying in patients with duodenal ulcer disease, suggesting a local rather than systemic effect.
Non-RCTInvestigation into the role of cephalic stimulation of acid secretion on gastric emptying and appetite following a soup meal using the gastric acid inhibitor omeprazole
Oral administration of a liquid soup preload does not cause cephalic stimulation of acid secretion, suggesting that gastric acid secretion is not responsible for the differences in gastric emptying and appetite observed between intragastric and orally administered preloads.
RCTOmeprazole delays gastric emptying in healthy volunteers: an effect prevented by tegaserod
Tegaserod effectively prevents the delayed gastric emptying effect of proton-pump inhibitors like omeprazole in healthy volunteers.
The effect of omeprazole on gastric emptying in patients with duodenal ulcer disease.
Omeprazole has no significant effect on gastric emptying in patients with duodenal ulcer disease, and its bioavailability is greater than required for total acid secretion suppression.
Non-RCTOmeprazole causes delay in gastric emptying of digestible meals
Omeprazole significantly delays gastric emptying of digestible solid meals in healthy subjects, mainly due to an effect on the slope of the emptying curve.
Non-RCTOmeprazole-induced slowing of gastrointestinal transit in mice can be countered with tegaserod.
Omeprazole slows gastrointestinal transit in mice, but this effect can be reversed by tegaserod, making it a potential treatment for dyspeptic symptoms.
Non-RCT
Animal StudyThe effect of omeprazole on gastric myoelectrical activity and emptying.
Omeprazole does not affect gastric motility but improves gastric myoelectrical activity, potentially contributing to its efficacy in relieving dyspeptic symptoms in functional dyspepsia patients.
Non-RCTThe effects of omeprazole on intragastric pH, intestinal motility, and gastric emptying rate.
Omeprazole disrupts the relationship between intragastric pH and intestinal motility, leading to a delay in gastric emptying of both liquid and solid foods, with a non-significant increase in postprandial motility duration.
RCT