Skip to main content
Log in

Loperamide abolishes exercise-induced orocecal liquid transit acceleration

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Previous work in our laboratory has found that mild physical activity accelerates mouth-to-large intestinal transit of lactulose in a mixed liquid meal. Because loperamide is commonly used as an antidiarrheal agent, we wondered if it would blunt the orocecal transit acceleration provoked by mild exercise. We investigated this equation in 12 healthy persons by comparing orocolonic liquid transit at rest and in mild exercise. Each subject ingested 8 mg loperamide 1 hr prior to study under both resting and exercise conditions. With loperamide treatment, exercise (walking at 5.6 km/hr) failed to hasten increased H2 excretion (mean transit time 72±12 min at rest, 90±15 min in exercise;P=NS). This result contrasts sharply with previously reported controls: loperamide completely abolished exercise-induced orocecal transit acceleration (−23±5 min in controls +18±13 min with loperamide;P<0.05). Compared with these same controls, resting transit was not significantly slowed by the drug, while transit in exercise was retarded (64±5 min in controls, 90±15 min with loperamide;P=0.06). Loperamide left unchanged the heart rate and oxygen uptake rises associated with exercise. In summary, by showing that loperamide blocks an exercise effect on the upper gut, these results suggest that the drug might prove effective in treating some gut symptoms induced by physical activity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. DuPont HL, Flores Sanchez J, Ericsson CD, Nediola Gomez J: Comparative efficacy of loperamide hydrochloride and bismuth subsalicylate in the management of acute diarrhea. Am J Med 88:155–195, 1990

    Google Scholar 

  2. Ooms LAA, Degryse A-D, Janssen PAJ: Mechanisms of action of loperamide. Scand J Gastroenterol 19:(suppl 96):145–155, 1984

    Google Scholar 

  3. Reynolds IJ, Gould RJ, Snyder SH: Loperamide: Blockade of calcium channels as a mechanism for anti-diarrheal effects. J Pharmacol Exp Ther 231:628–632, 1984

    Google Scholar 

  4. Burleigh DE: Opioid and non-opioid actions of loperamide on cholinergic nerve function in human isolated colon. Eur J Pharmacol 152:39–46, 1988

    Google Scholar 

  5. Kachel G, Ruppin H, Hagel J, Barina W, Meinhardt M, Domschke W: Human intestinal motor activity and transport: Effects of a synthetic opiate. Gastroenterology 90:85–93, 1986

    Google Scholar 

  6. Sninsky CA, Davis RH, Clench MH, Thomas KD, Mathias JR: Effect of lidamidine hydrochloride and loperamide on gastric emptying and transit of the small intestine. Gastroenterology 90:68–73, 1986

    Google Scholar 

  7. Keeling WF, Martin BJ: Gastrointestinal transit during mild exercise. J Appl Physiol 63:978–981, 1987

    Google Scholar 

  8. Keeling WF, Harris A, Martin BJ: Orocecal transit during mild exercise in women. J Appl Physiol 68:1350–1353, 1990

    Google Scholar 

  9. Fogoros, RN: Gastrointestinal disturbances in runners. JAMA 243:1943–1944, 1980

    Google Scholar 

  10. Sullivan SN: The effect of running on the gastrointestinal tract. J Clin Gastroenterol 6:461–465, 1984

    Google Scholar 

  11. Keeffe EB, Lowe DK, Goss JR, Wayne R: Gastrointestinal symptoms of marathon runners. West J Med 141:481–484, 1984

    Google Scholar 

  12. Turnbull GK, Thompson DG, Day S, Martin J, Walker E, Lennard-Jones JE: Relationship between symptoms, menstrual cycle and orocecal transit in normal and constipated women. Gut 30:30–34, 1989

    Google Scholar 

  13. Shepherd RJ: Learning, habituation, and training. Int Z Angew Physiol 28:38–48, 1969

    Google Scholar 

  14. O'Brien JD, Thompson DG, McIntyre A, Burnham WR, Walker E: Effect of codeine and loperamide on upper intestinal transit and absorption in normal subjects and patients with postvagotomy diarrhea. Gut 29:312–318, 1988

    Google Scholar 

  15. Åstrand P-O, Rhyming J: A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during submaximal work. J Appl Physiol 7:218–221, 1954

    Google Scholar 

  16. Staniforth DH, Rose D: Statistical analysis of the lactulose/breath hydrogen test in the measurement of orocecal transit: Its variability and predictive value in assessing drug action. Gut 30:171–175, 1989

    Google Scholar 

  17. Bond JH, Levitt MD: Investigation of small bowel transit time in man utilizing pulmonary hydrogen (H2) measurements. J Lab Clin Med 85:546–555, 1975

    Google Scholar 

  18. Guadin C, Zerath E, Guezennec CY: Gastric lesions secondary to long-distance running. Dig Dis Sci 35:1239–1243, 1990

    Google Scholar 

  19. Holdstock DJ, Misiewicz JJ, Smith T, Rowland EN: Propulsion (mass movements) in the human colon and its relationship to meals and somatic activity. Gut 11:91–99, 1970

    Google Scholar 

  20. Schiller LR, Santa Ana CA, Morawski SG, Fordtran JS: Mechanism of antidiarrheal effect of loperamide. Gastroenterology 86:1475–1480, 1984

    Google Scholar 

  21. Basilisco G, Camboni G, Bozzani A, Paravicini M, Bianchi PA: Oral naloxone antagonizes loperamide-induced delay of orocecal transit. Dig Dis Sci 32:829–832, 1987

    Google Scholar 

  22. Harris A, Keeling WF, Martin BJ: Identical orocecal transit time and serum motilin in hyperthermia and normothermia. Dig Dis Sci 35:1281–1284, 1990

    Google Scholar 

  23. Lenz HJ: Neurohumoral pathways mediating stress-induced changes in rat gastrointestinal transit. Gastroenterology 97:216–218, 1989

    Google Scholar 

  24. O'Brien JD, Thompson DG, Day SJ, Burnham WR, Walker E: Perturbation of upper gastrointestinal transit and antroduodenal motility by experimentally applied stress: the role of beta-adrenoreceptor mediated pathways. Gut 30:1530–1539, 1989

    Google Scholar 

  25. O'Brien JD, Thompson DG, Burnham WR, Holly J, Walker E: Action of centrally mediated autonomic stimulation on upper gastrointestinal transit: a comparative study of two stimuli. Gut 28:960–969, 1987

    Google Scholar 

  26. McMurray RG, Forsythe WA, Mar MH, Hardy CJ: Exercise intensity-related responses of β-endorphin and catecholamines. Med Sci Sports Exer 19:570–574, 1987

    Google Scholar 

  27. Rowell LB, Blackmon JR, Bruce RA: Indocyanine green clearance and estimated hepatic blood flow during mild to maximal exercise in upright man. J Clin Invest 43:1677–1690, 1964

    Google Scholar 

  28. Oltras CM, Mora F, Vives F: Beta-endorphin and ACTH in plasma: effects of physical and psychological stress. Life Sci 40:1683–1686, 1987

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Keeling, W.F., Harris, A. & Martin, B.J. Loperamide abolishes exercise-induced orocecal liquid transit acceleration. Digest Dis Sci 38, 1783–1787 (1993). https://doi.org/10.1007/BF01296099

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01296099

Key Words

Navigation