Erythromycin, motilin, and the esophagus.
BACKGROUND
Motilin induces phase III activity of the gastroesophageal tract. Erythromycin has a motilin-like effect on the stomach, but possible esophageal effects have not been evaluated and are the focus of our investigation.


METHODS
Esophageal manometry was performed in 11 healthy volunteers before and after intravenous infusion of 500 mg erythromycin. Values are expressed as means +/- SEM.


RESULTS
Lower esophageal sphincter (LES) pressure increased from 21.1 +/- 2.6 mm Hg at baseline to 37.5 +/- 3.8 mm Hg after erythromycin infusion (p < 0.0001). Erythromycin did not affect LES length, esophageal body contraction amplitude, duration or velocity, or the upper esophageal sphincter. Serum motilin levels decreased from 96.4 +/- 10.9 pmol/L to 81.8 +/- 10.9 pmol/L (p < 0.01) after erythromycin administration.


CONCLUSIONS
Erythromycin profoundly stimulates the normal human LES. This is a direct motilin agonist-like effect and is not mediated by release of endogenous motilin. Erythromycin has no important effect on the esophageal body or the upper esophageal sphincter.
Pennathur
A
A
Department of Surgery, University of Nevada School of Medicine, Las Vegas.
Cioppi
M
M
Fayad
J B
JB
Little
A G
AG
D000328:Adult; D004917:Erythromycin / Q000494:pharmacology*; D004947:Esophagus / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009037:Motilin / Q000494:pharmacology*; D009119:Muscle Contraction / Q000187:drug effects; D016065:Myoelectric Complex, Migrating / Q000187:drug effects; D011312:Pressure
D009037:Motilin; D004917:Erythromycin