The effects of tegaserod on oesophageal function and bolus transport in healthy volunteers: studies using concurrent high-resolution manometry and videofluoroscopy.
BACKGROUND
Tegaserod is a partial 5-hydroxytryptamine 4 receptor agonist with prokinetic effects on the gastrointestinal tract, its effects on oesophageal function are unknown.


OBJECTIVE
A randomized, placebo controlled, double-blind trial assessed the effect of tegaserod on the oesophagus in healthy, asymptomatic subjects.


METHODS
A 7-day course of tegaserod 6 mg b.d. vs. placebo was prescribed (n = 17/21 completed both phases of study). High-resolution manometry and pH measurements were performed before and after a test meal. Bolus transport of liquids and solids was studied by high-resolution manometry and videofluoroscopy.


RESULTS
Tegaserod had no effect on lower oesophageal sphincter pressure compared with placebo, peristaltic velocity increased (P < 0.001) and distal contractile pressure decreased slightly (P < 0.05). Transient lower oesophageal sphincter relaxations and reflux were infrequent regardless of treatment. During the studies of bolus transport, high-resolution manometry revealed that tegaserod promoted mid-oesophageal contractility (P < 0.02) and shortened the 'proximal transition zone' (P < 0.05), the level where bolus escape occurred most frequently. These effects had no effect on liquid bolus transport; however a non-significant trend to improved solid bolus transport was observed (66% vs. 31%;P = 0.07).


CONCLUSIONS
Tegaserod did not alter lower oesophageal sphincter pressure, but had significant effects on peristaltic function. High-resolution manometry promoted mid-oesophageal contractility during bolus transport. This effect was associated with a non-significant trend to improved solid bolus transit.
Fox
M
M
Department of Gastroenterology and Hepatology, University Hospital of Zürich, Rämistrasse, Zürich, Switzerland. markfox_2@hotmail.co.uk
Menne
D
D
Stutz
B
B
Fried
M
M
Schwizer
W
W
D000328:Adult; D004311:Double-Blind Method; D004947:Esophagus / Q000502:physiology* / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D008297:Male; D008365:Manometry / Q000379:methods*
D005765:Gastrointestinal Agents; D007211:Indoles; C105050:tegaserod