J Neurogastroenterol Motil.  2016 Jan;22(1):112-117. 10.5056/jnm15130.

Effects of Metoclopramide on Esophageal Motor Activity and Esophagogastric Junction Compliance in Healthy Volunteers

• Mikami H
• Ishimura N
• Fukazawa K
• Okada M
• Izumi D
• Shimura S
• Okimoto E
• Aimi M
• Ishihara S
• Kinoshita

• KMID: 2379710
• DOI: http://doi.org/10.5056/jnm15130

Abstract

BACKGROUND/AIMS
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 mm2/mmHg), suggesting no significant effect of metoclopramide on EGJ compliance.
CONCLUSIONS
Metoclopramide augmented esophageal contractions without changing EGJ compliance in healthy adults.

Keyword

Esophageal sphincter, lower; Esophagogastric junction; Manometry; Metoclopramide; Motor Activity

MeSH Terms

Adult
Compliance*
Esophageal Sphincter, Lower
Esophagogastric Junction*
Gastroesophageal Reflux
Hand
Healthy Volunteers*
Humans
Male
Manometry
Metoclopramide*
Motor Activity*
Volunteers
Metoclopramide