Parenteral erythromycin for potential use to empty retained gastric contents encountered during upper gastrointestinal endoscopic procedures

Background: Erythromycin, a prokinetic agent facilitates gastric emptying. We report our experience with the use of IV erythromycin for emptying retained gastric contents encountered during elective upper gastrointestinal endoscopy (UGIE) procedures in an effort to complete of the procedure on the same day. Patients and methods: This retrospective case series includes 15 patients who were found to have a signifycant amount of retained gastric contents while undergoing an UGIE procedure. After aborting the procedure, a repeat endoscopic examination was performed 30 - 120 minutes following administration of 250 - 500 mg erythromycin intravenously. Results: During repeat endoscopy, ten patients had complete emptying of the gastric contents, three patients had partial emptying and in two patients the amount of residual contents was largely unchanged. Both these patients were later found to have high grade mechanical gastric outlet obstruction. No anesthesia or procedure related complications were noted. Conclusion: Parenteral erythromycin can rapidly empty retained gastric contents encountered during UGIE procedures in a significant proportion of patients. Erythromycin can potentially be tried for safe completion of procedure on the same day.