Free Content Effects of alosetron on gastrointestinal transit time and rectal sensation in patients with irritable bowel syndrome

Authors: Thumshirn1; Coulie1; Camilleri1; Zinsmeister2; Burton1; Van Dyke,1

Source: Alimentary Pharmacology & Therapeutics, Volume 14, Number 7, July 2000 , pp. 869-878(10)

Publisher: Blackwell Publishing

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Abstract:

Background: 

Alosetron, a 5-HT3-receptor antagonist, relieves abdominal pain and improves bowel function in non-constipated, female patients with irritable bowel syndrome. 5-HT3 antagonists delay colonic transit, increase colonic compliance, and increase small intestinal water absorption. Aim: 

To evaluate the effects of alosetron on gastrointestinal and colonic transit, rectal compliance and rectal sensation in irritable bowel syndrome. Methods: 

A double-blind, placebo-controlled, two-dose study of alosetron was performed in 25 non-constipated irritable bowel syndrome patients, with paired studies before and after 4 weeks of treatment with placebo (n=5), 1 mg alosetron (n=10) or 4 mg (n=10) alosetron b.d. Gastrointestinal and colonic transit were measured by scintigraphy. Rectal compliance and sensation were assessed by rectal balloon distention with a barostat. Results: 

There was a trend (P=0.06) for 1 mg alosetron to increase rectal compliance (median pressure at half maximum volume 11 mmHg after alosetron vs. 15.6 mmHg before alosetron). The 1 mg b.d. alosetron dose non-significantly retarded proximal colonic transit. Alosetron and placebo reduced sensory scores relative to baseline values; none of the changes induced by alosetron was significant relative to placebo. Conclusions: 

Alosetron had no significant effect on gastrointestinal transit or rectal sensory and motor mechanisms in non-constipated irritable bowel syndrome patients in this study. Alosetron's effects on colonic sensorimotor function and central sensory mechanisms deserve further evaluation.

Document Type: Research article

DOI: 10.1046/j.1365-2036.2000.00786.x

Affiliations: 1: Gastroenterology Research Unit, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA, 2: Section of Biostatistics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA

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