Effect of sucralfate and an aluminum hydroxide gel on gastric emptying of solids and liquids.

Our purpose was to investigate whether an aluminum-containing compound (sucralfate) and an aluminum-containing antacid (Amphojel; Wyeth Laboratories), both of which are commonly used in peptic ulcer disease, affect gastric emptying. Gastric emptying was studied in ten healthy subjects with the double isotope technique to assess simultaneous emptying rates of the solid and liquid components of a meal. 99mTechnetium sulfur colloid-labeled chicken liver served as the solid component and 111indium diethylenetriamine penta-acetic acid-labeled water was the liquid component. In a randomized, double-blind fashion, 1 gm sucralfate and 30 ml aluminum hydroxide gel were compared with placebo on separate days. Subjects ate the isotope-labeled test meal after dosing, and gastric emptying was monitored for 3 hours by a gamma-camera interfaced with a computer. There was no significant change in gastric emptying of either solids or liquids after sucralfate. The aluminum hydroxide gel slowed the gastric emptying rate for solids more than did the placebo, but this difference was significant only at the intervals of 165 and 180 minutes after the meal. We conclude that aluminum in the form of therapeutic doses of sucralfate does not delay gastric emptying of solids or liquids in normal subjects, while the larger amount of aluminum in therapeutic doses of the antacid gel has some slowing effect on gastric emptying of the solid components of a meal.

Acute pancreatitis associated with bulimia.

Acute pancreatitis developed in an 18-year-old woman after multiple episodes of bulimia. The pancreatitis was severe and the patient developed a pseudocyst. Eating disorders may be associated with acute pancreatitis, and so we review the literature on this possibility.

Tuberous sclerosis complex: review of the gastrointestinal manifestations and report of an unusual case.

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder that can affect any organ of the body. We report the first case of advanced colonic adenocarcinoma in a patient with well-documented TSC, offer rationales for the association of this lesion with TSC, and review the literature pertaining to gastrointestinal involvement of this complex.

Exudative ascites complicating infectious mononucleosis.

A case of Epstein-Barr virus mononucleosis with the unusual complication of exudative ascites is presented. The patient was a 22-yr-old man with the typical symptoms and physical findings of hepatitis secondary to infectious mononucleosis. Extensive evaluation including liver biopsy, failed to show another cause for the patient's ascites. The ascites and hepatitis disappeared with resolution of the acute mononucleosis infection. He is well 12 months after this illness with no evidence for chronic liver disease. This case adds to the list of causes for exudative ascites associated with acute hepatitis.