Gastric emptying in myotonic dystrophy

Background Gastrointestinal symptoms are common and important for the quality of life in patients with myotonic dystrophy (MD). Gastric emptying was studied in patients with MD who suffered from symptoms suggesting slow gastric emptying and the effect of prokinetic treatment was evaluated. Methods Gastric emptying was studied in 10 patients with MD who were suffering from nausea, early satiety, bloating, regurgitation, vomiting, or abdominal pain using a 99Tc-labelled test meal, and was compared with gastric emptying in a group of healthy controls. The patients were subsequently treated with erythromycin and their gastrointestinal symptoms were recorded and the gastric emptying test was repeated. Results Patients with MD had a significantly longer gastric lag phase (46·1 ± 4·3 vs. 31·9 ± 4·0 min, P = 0·03), a slower emptying phase (7·1 ± 0·9 vs. 10·2 ± 0·9 kJ min−1, P = 0·02) and a longer half-emptying time, T50 (141·7 ± 10·5 vs. 98·6 ± 8·7 min, P = 0·01) than a matched control group. Erythromycin did not stimulate the gastric emptying rate. The effect on gastrointestinal symptoms was modest, except for a reduction of diarrhoea. Conclusions Patients with MD suffering from nausea, vomiting and early satiety, displayed a slow gastric emptying. Treatment with erythromycin had only moderate effect on gastric emptying or gastric symptoms, but reduced diarrhoea in a majority of the patients.