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Background: The antidyspeptic property of mineral waters has been based for ages on empirical data. In the present paper the effects of one of them (Tettuccio, Montecatini) on gastrointestinal motility of patients with dyspepsia has been evaluated., Methods: The study was carried out on 24 patients with idiopathic dyspepsia and delayed gastric emptying at scintigraphy and 18 healthy subjects with normal gastric emptying. The gastric emptying of this mineral water was studied with a scintigraphic method in comparison with tap water, while its effects on gastroduodenal contractions were evaluated by of manometry., Results: The gastric emptying of this mineral water was significantly faster than that of tap water, both in dyspeptic patients and in normals. Manometric examination showed that the administration of mineral water induced a brief decrease of phasic motor activity, followed by a progressive increase, which in some cases ended in an activity front of the Migrating Motor Complex., Conclusions: This mineral water has a stimulating effect on both gastric emptying and interdigestive cyclic motor activity of the gastroduodenal tract. Both these effects could be useful in the treatment of chronic idiopathic dyspepsia and impaired gut clearing.

The authors evaluate the influence of a sulphate-bicarbonate mineral water on gastric emptying and cholecystic motility. Nine healthy volunteers drunk at settled intervals and with same procedures equal doses of mineral water and tap water on alternate days. Ultrasonographic evaluation of the gastric emptying and cholecystic volumes was performed before and after mineral water and top water drinks at settled intervals. The mean values of the gastric and the cholecystic volumes were calculated and compared at the single times. The results showed a significant colecystocinetic effect of the mineral water compared with tap water. No difference was observed in the gastric emptying with the mineral and tap water. Our work contributes to the knowledge of the pharmacodynamic effects of the mineral water employed and confirms its usefulness in the syndromes based on alterations in bile secretion and bile excretion in duodenum.

Levosulpiride, a dopaminergic antagonist was compared in a double-blind randomized study with domperidone for treatment of functional dyspepsia in 50 patients divided into two groups of 25 subjects each. Group I received 25 mg levosulpiride 3 times daily, group II received 10 mg domperidone 3 times daily, all for 30 days. Periodic clinical examination at days 0, 7, 15, 30 showed symptomatic changes. Gallbladder and gastric emptying was studied by ultrasonography at the start and end of treatment. Both drugs had a positive influence on dyspeptic symptoms and on gastric and gallbladder emptying, but the latter parameters were improved significantly more effectively by levosulpiride. As to tolerability, there have been 3 drop-outs and a further 6 patients complained of sides effects that did not require suspension of treatment.

The efficacy and tolerability of Cisapride effervescent granules and a metoclopramide-dimethicone combination were compared double-blind in two comparable groups of 15 patients each with dyspepsia. All patients received three sachets daily of either drug for 6 consecutive weeks. As for efficacy, Cisapride effervescent granules was found to reduce 85% (11/13) of symptoms to a statistically significant extent, as against 42% (5/12) in the reference group. Statistical analysis showed Cisapride effervescent granules to be more effective than the reference drug for 6 out of 11 evaluable symptoms. Mean global improvement was 86% for Cisapride effervescent granules vs 41% for the reference combination. Final judgment by the physician was more favorable for Cisapride effervescent granules than for the reference drug (p < 0.0001). Treatment withdrawal was never necessary and no significant changes of laboratory values were observed. No statistically significant difference between the two treatments as to tolerability was observed. In conclusion, Cisapride effervescent granules was found to have a better risk/benefit ratio than the reference combination.

In 10 healthy patients gastric and gallbladder emptying after a standard meal (800 cal, 60% glucides, 20% protides, 20 lipids) associated with 400 ml alkaline bicarbonated water or tap water were evaluated by ultrasonography. An increase of gastric emptying was noted after alkaline bicarbonated water versus tap water with significant differences at 30' (p less than 0.05), 60' (p less than 0.01) and 120' (p less than 0.05). No significant differences exist in final gastric emptying time. Alkaline bicarbonated water induced less intensive gallbladder emptying with statistical difference versus tap water at 60' and 120' from the standard meal (p less than 0.01).

The authors studied the action of clebopride on gastric emptying in subjects with non-ulcer dyspepsia by using radioactive isotopes. Eighteen subjects complaining of dyspeptic symptoms were studied in whom the tests undertaken had not shown organic lesions of the digestive tract. Tests with radioactive isotopes were performed before and after administration of clebopride (0.5 mg, three times daily for 15 days). In all patients gastric emptying time was normalized and gastric peristalsis became regular. In addition, in 85% of the patients, symptoms disappeared or were markedly reduced. Side effects requiring withdrawal of the drug were not observed. The above study, therefore, showed clebopride to be a useful drug for the treatment of non-ulcer dyspepsia, thus confirming data found in the literature.

The influence of Thyropramide, a recently developed spasmolytic on the gastric emptying times of a solid meal was assessed in 10 healthy subjects aged 23-54. Thyropramide (300 mg per diem for 3 days per os) does not significantly modify gastric emptying time compared to the placebo though a slight average increase in T 1/2 was noted. No side effects were noted during the study. Thyropramide therefore appears to have a spasmolytic effect on the large intestine without in any way influence the stomach either proximally or distally.

When the cause of oesophagitis has been discovered, patients for whom surgical management is impossible may be successfully treated by improving oesophageal peristalsis, increasing the tone of the LES, and speeding up the emptying of the stomach. The best results are obtained in peptic oesophagitis, since the latest secretion-inhibiting drugs ensure constant reduction of the acidity of the gastric juice, as has been demonstrated by continuous pH monitoring.