The effect of sildenafil on segmental oesophageal motility and gastro-oesophageal reflux.
BACKGROUND
Sildenafil is an inhibitor of type 5 phosphodiesterase. It relaxes or inhibits contraction of smooth muscle by increasing cellular concentrations of cyclic guanosine monophosphate. Multichannel intraluminal impedance manometry/pH allow the precise evaluation of oesophageal bolus transit and acid/non-acid reflux.


OBJECTIVE
To investigate the effect of sildenafil on segmental oesophageal motor function and gastro-oesophageal reflux.


METHODS
Eight healthy volunteers underwent multichannel intraluminal impedance manometry baseline, and 15, 30 and 45 min before and after a 50-mg dose of sildenafil successively. The subjects underwent 2-h multichannel intraluminal impedance/pH studies on two separate days after either water or sildenafil ingestion.


RESULTS
Sildenafil decreased the resting lower oesophageal sphincter pressure and prolonged the duration of lower oesophageal sphincter relaxation for the 45 min following its ingestion. At 15 min, distal onset velocity, total bolus transit time, bolus presence time and segmental transit time were delayed in the mid to distal oesophagus. At 30 min, distal onset velocity was restored but bolus presence time and bolus presence time were still delayed in distal smooth muscle segment. At 45 min, total bolus transit time and distal onset velocity were restored but bolus presence time and segmental transit time were delayed more in the transition zone. Sildenafil did not alter the reflux.


CONCLUSIONS
Sildenafil alters lower oesophageal sphincter function and oesophageal bolus transit, but not induce gastro-oesophageal reflux.
Kim
H S
HS
Department of Internal Medicine, Brain Korea 21 Project, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Yongdong, Seoul, Korea.
Conklin
J L
JL
Park
H
H
D000328:Adult; D015154:Esophageal Motility Disorders / Q000188:drug therapy*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D005772:Gastrointestinal Transit / Q000187:drug effects; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry / Q000379:methods; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*
D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate