{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T19:07:27Z","timestamp":1787598447216,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,5,14]],"date-time":"2012-05-14T00:00:00Z","timestamp":1336953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2012,7]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Loperamide (LOP<\/jats:styled-content>) is an anti\u2010diarrhoeal agent which is thought to act largely by slowing transit with an uncertain effect on the fluid content of the small and large bowel in humans. Adding simethicone (SIM<\/jats:styled-content>) to LOP<\/jats:styled-content> improves its efficacy, but the mechanism of interaction is unclear. Novel MRI<\/jats:styled-content> techniques to assess small bowel water content (SBWC<\/jats:styled-content>) have shown that mannitol solutions markedly increase SBWC<\/jats:styled-content> and can be used as a model of diarrhoea.<\/jats:p><\/jats:sec>Aim<\/jats:title>We aimed to use quantitative MRI<\/jats:styled-content> techniques to compare the actions in the gut of LOP<\/jats:styled-content> and LOP<\/jats:styled-content> + SIM<\/jats:styled-content> in a model of secretory diarrhoea using mannitol.<\/jats:p><\/jats:sec>Methods<\/jats:title>A total of 18 healthy volunteers ingested capsules containing placebo (PLA<\/jats:styled-content>) or 12\u00a0mg LOP<\/jats:styled-content> or 12\u00a0mg LOP<\/jats:styled-content> + 125\u00a0mg SIM<\/jats:styled-content>. After 100\u00a0min they were given a drink containing 5% mannitol in 350\u00a0mL of water. They underwent baseline fasting and postprandial serial MRI<\/jats:styled-content> scans at 45\u00a0min intervals for 4.5\u00a0h after ingesting the drink. A range of MRI<\/jats:styled-content> sequences was acquired to image the gut.<\/jats:p><\/jats:sec>Results<\/jats:title>LOP<\/jats:styled-content> and LOP<\/jats:styled-content> + SIM<\/jats:styled-content> significantly accelerated gastric emptying (P<\/jats:italic>\u00a0<\u00a00.03) and reduced SBWC<\/jats:styled-content> during the late phase (135\u2013270\u00a0min after mannitol ingestion), P\u00a0<\/jats:italic><\u00a00.009, while delaying arrival of fluid in the ascending colon (AC<\/jats:styled-content>). The relaxation time T<\/jats:styled-content>2 of the contents of the AC<\/jats:styled-content> was reduced by both drugs (P\u00a0<\/jats:italic><\u00a00.0001).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>LOP<\/jats:styled-content> and LOP<\/jats:styled-content> + SIM<\/jats:styled-content> accelerate gastric emptying, but reduce small bowel water content which may contribute to the delay in oral\u2010caecal transit and overall anti\u2010diarrhoeal effect.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2036.2012.05127.x","type":"journal-article","created":{"date-parts":[[2012,5,15]],"date-time":"2012-05-15T00:57:35Z","timestamp":1337043455000},"page":"64-73","source":"Crossref","is-referenced-by-count":25,"title":["The effects of loperamide, or loperamide plus simethicone, on the distribution of gut water as assessed by MRI<\/scp> in a mannitol model of secretory diarrhoea"],"prefix":"10.1111","volume":"36","author":[{"given":"E.","family":"Placidi","sequence":"first","affiliation":[{"name":"Sir Peter Mansfield Magnetic Resonance Centre University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Marciani","sequence":"additional","affiliation":[{"name":"Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit Queen's Medical Centre Campus Nottingham University Hospitals University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. L.","family":"Hoad","sequence":"additional","affiliation":[{"name":"Sir Peter Mansfield Magnetic Resonance Centre University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Division of Radiological and Imaging Sciences Queen's Medical Centre University of Nottingham Nottingham UK"},{"name":"Department of Occupational Health and Safety, Medical Physics Bambino Ges\u00f9 Children's Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. C.","family":"Garsed","sequence":"additional","affiliation":[{"name":"Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit Queen's Medical Centre Campus Nottingham University Hospitals University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. E.","family":"Pritchard","sequence":"additional","affiliation":[{"name":"Sir Peter Mansfield Magnetic Resonance Centre University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. F.","family":"Cox","sequence":"additional","affiliation":[{"name":"Sir Peter Mansfield Magnetic Resonance Centre University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Costigan","sequence":"additional","affiliation":[{"name":"Sir Peter Mansfield Magnetic Resonance Centre University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. C.","family":"Spiller","sequence":"additional","affiliation":[{"name":"Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit Queen's Medical Centre Campus Nottingham University Hospitals University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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