Effects of Metoclopramide on Esophageal Motor Activity and Esophagogastric Junction Compliance in Healthy Volunteers.
OBJECTIVE
Prokinetic drugs such as metoclopramide are frequently used as second-line therapy for patients with gastroesophageal reflux disease. However, their beneficial effects remain unclear. Esophageal motor activities and compliance of the esophagogastric junction (EGJ) are important for prevention of gastroesophageal reflux. Although metoclopramide has been reported to increase lower esophageal sphincter (LES) pressure, its effects on EGJ compliance have not been evaluated. In the present study, we investigated the effects of metoclopramide on esophageal motor activities and EGJ compliance.


METHODS
Nine healthy male volunteers without abdominal symptoms were enrolled. Peristaltic esophageal contractions and LES pressure were examined using high-resolution esophageal manometry, while EGJ compliance was evaluated with an endoluminal functional lumen-imaging probe. After obtaining baseline values for esophageal motor activities and EGJ compliance, metoclopramide (10 mg) was intravenously administered, then all measurements were repeated at 15 minutes after administration in each subject.


RESULTS
Following administration of metoclopramide, mean resting LES pressure was significantly increased as compared with the baseline (13.7 ± 9.2 vs 26.7 ± 8.8 mmHg, P < 0.05). In addition, metoclopramide significantly augmented peristaltic contractions, especially in the distal esophageal segment (P < 0.05). On the other hand, distensibility index did not change after administration (4.5 ± 0.5 vs 4.1 ± 0.5 mm(2)/mmHg), suggesting no significant effect of metoclopramide on EGJ compliance.


CONCLUSIONS
Metoclopramide augmented esophageal contractions without changing EGJ compliance in healthy adults.
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
Hironobu
H
Mikami
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
Norihisa
N
Ishimura
Department of Gastroenterology and Hepatology, Kasai City Hospital, Kasai, Japan.
Kousuke
K
Fukazawa
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
Mayumi
M
Okada
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
Daisuke
D
Izumi
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
Shino
S
Shimura
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
Eiko
E
Okimoto
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
Masahito
M
Aimi
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
Shunji
S
Ishihara
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
Yoshikazu
Y
Kinoshita
Esophageal sphincter; Esophagogastric junction; Manometry; Metoclopramide; Motor Activity; lower