Skip to main content
SpringerLink
Log in

Lack of effect of metoclopramide and domperidone on esophageal peristalsis and esophageal acid clearance in reflux esophagitis

A randomized, double-blind study

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

The acute effects of oral metoclopramide (40 mg/day) and domperidone (80 mg/day) on esophageal motor activity and acid reflux were assessed in a randomized, double-blind, placebo-controlled study in 20 patients with erosive reflux esophagitis. Esophageal motor function was assessed by standard manometry with wet swallows, and reflux events were evaluated by ambulatory 24-hr pH-monitoring. Both drugs caused a significant (P<0.05) increase in lower esophageal sphincter pressure lasting at least 120 min. However, neither esophageal body motility, duration of esophageal exposure to acid, nor esophageal clearance were effected by drug administration in comparison to placebo. Side effects were reported in two patients who received metoclopramide, while no adverse effects occurred after domperidone intake. In conclusion, the so-called motility agents metoclopramide and domperidone have few acute effects on esophageal motility in patients with erosive reflux esophagitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Dodds WJ, Hogan WJ, Helm JF, Dent J: Pathogenesis of reflux esophagitis. Gastroenterology 81:376–384, 1981

    Google Scholar 

  2. Kahrilas PJ, Dodds WJ, Hogan WJ, Kern M, Arndorfer RC, Reece A: Esophageal peristaltic dysfunction in peptic esophagitis. Gastroenterology 91:897–904, 1986

    Google Scholar 

  3. Gill RC, Bowes KL, Murphy PD, Kingma YJ: Esophageal motor abnormalities in gastroesophageal reflux and the effects of fundoplication. Gastroenterology 91:364–369, 1986

    Google Scholar 

  4. Grande L, Lacima G, Ros E, Pujol A, García-Valdecasas JC, Fuster J, Visa J, Pera C: Dysphagia and esophageal motor dysfunction in patients with gastroesophageal reflux disease are corrected by fundoplication. J Clin Gastroenterol 13:11–16, 1991

    Google Scholar 

  5. McCallum RW, Kline M, Curry N, Sturdevant R: Comparative effects of metoclopramide and bethanechol on lower esophageal sphincter pressure in reflux patients. Gastroenterology 68:1114–1118, 1975

    Google Scholar 

  6. Cohen S, Morris DW, Schoen HJ, DiMarino AJ: The effect of oral and intravenous metoclopramide on human lower esophageal sphincter pressure. Gastroenterology 70:484–487, 1976

    Google Scholar 

  7. Weihrauch TR, Förster ChF, Krieglstein J: Evaluation of the effect of domperidone on human oesophageal and gastroduodenal motility by intraluminal manometry. Postgrad Med J 55:7–10, 1979

    Google Scholar 

  8. Cuchiara S, Staiano A, Boccieri A, DeStefano M, Capozzi C, Manzi G, Camerlingo F, Paone FM: Effects of cisapride on parameters of esophageal motility and on the prolonged intraesophageal pH test in infants with gastroesophageal reflux disease. Gut 31:21–25, 1990

    Google Scholar 

  9. Pignon JP, Poynard T, Naveau S, Sebag G, Chapput JC: Critical review of randomized double-blind trials in the treatment of gastroesophageal reflux. Gastroenterol Clin Biol 11:668–680, 1987

    Google Scholar 

  10. Albibi R, McCallum RW: Metoclopramide: pharmacology and clinical application. Ann Intern Med 98:86–95, 1983

    Google Scholar 

  11. Reyntjens AJ, Niemegeers CJE, Van Neuten JM, Laduron P, Heykants J, Schellekens KHL, Marsboom R, Jageneau A, Broekaert A, Janssen PAJ: Domperidone, a novel and safe gastrokinetic antinauseant for the treatment of vomiting and dyspepsia. Arzneim Forsch 28:1194–1195, 1978

    Google Scholar 

  12. Pujol A, Grande L, Ros E, Pera C: Utility of inpatient 24-hour intraesophageal pH monitoring in diagnosis of gastroesophageal reflux. Dig Dis Sci 33:1134–1140, 1988

    Google Scholar 

  13. Johnson LF, DeMeester TR: Twenty-four hour monitoring of the distal esophagus. Am J Gastroenterol 62:325–332, 1974

    Google Scholar 

  14. DeMeester TR, Wang CI, Wernly JA, Pellegrini CA, Little AG, Klementschitsch P, Bermudez G, Johnson LF, Skinner DB: Technique, indications and clinical use of 24 hour esophageal pH monitoring. J Thorac Cardiovasc Surg 79:656–670, 1980

    Google Scholar 

  15. Wallin L, Boesby S, Madsen T: Effect of metoclopramide on esophageal peristalsis and gastroesophageal pressure. Scand J Gastroenterol 14:923–927, 1979

    Google Scholar 

  16. DiPalma JA, Perucca PJ, Martin DF, Pierson WP, Meyer GW: Metoclopramide effect on esophageal peristalsis in normal human volunteers. Am J Gastroenterol 82:307–310, 1987

    Google Scholar 

  17. Bron B, Massih L: Domperidone: a drug with powerful action on the lower esophageal sphincter pressure. Digestion 20:375–378, 1980

    Google Scholar 

  18. Wallin L, Madsen T, Boesby S: Effect of domperidone on gastroesophageal function in normal subjects. Scand J Gastroenterol 20:150–154, 1985

    Google Scholar 

  19. Stanciu C, Bennet JR: Metoclopramide in gastroesophageal reflux. Gut 14:678–680, 1973

    Google Scholar 

  20. Behar J, Biancani P: Effect of oral metoclopramide on gastroesophageal reflux in the post-cibal state. Gastroenterology 70:331–335, 1976

    Google Scholar 

  21. McCallum RW, Ippoliti AF, Cooney C, Sturdevant RAL: A controlled trial of metoclopramide in symptomatic gastroesophageal reflux. N Engl J Med 296:354–357, 1977

    Google Scholar 

  22. McCallum RW, Fink SM, Winnan GR, Avella J, Callachan C: Metoclopramide in gastroesophageal reflux disease: rationale for its use and results of a double-blind trial Am J Gastroenterol 79:165–172, 1984

    Google Scholar 

  23. Tolia V, Calhoun J, Kuhns L, Kauffman RE: Randomized, prospective double-blind trial of metoclopramide and placebo for gastroesophageal reflux in infants. J Pediatr 115:141–145, 1989

    Google Scholar 

  24. Burns TW, Venturatos S, Hartley L, Diavolitsis S: Effects of metoclopramide and bethanechol on esophageal motility: is there synergism? Gastroenterology 86:1037, 1984

    Google Scholar 

  25. Hyams JS, Leitcher AM, Zame HLO, Walters JK: Effect of metoclopramide on prolonged intraesophageal pH testing in infants with gastroesophageal reflux. J Pediatr Gastroenterol Nutr 5:716–719, 1986

    Google Scholar 

  26. Machida HM, Forbes DA, Gall DG, Scott RB: Metoclopramide in gastroesophageal reflux in infancy. J Pediatr 112:483–487, 1988

    Google Scholar 

  27. DeMeester TR, Johnson LF, Joseph GJ, Toscano MS, Hall AW, Skinner DB: Patterns of gastroesophageal reflux in health and disease. Ann Surg 184:459–469, 1987

    Google Scholar 

  28. Grande L, Pujol A, Ros E, García-Valdecasas JC, Fuster J, Visa J, Pera C: Intraesophageal pH monitoring after breakfast+luch in gastroesophageal reflux. J Clin Gastroenterol 10:373–376, 1988

    Google Scholar 

  29. Dent J, Holloway RH, Toouli J, Dodds WJ: Mechanisms of lower esophageal sphincter incompetence in patients with symptomatic gastroesophageal reflux. Gut 29:1020–1028, 1988

    Google Scholar 

  30. Helm JF, Dodds WJ, Reidel DR, Teeter BC, Hogan WJ, Arndorfer RC: Determinants of esophageal and acid clearance in normal subjects. Gastroenterology 85:607–612, 1983

    Google Scholar 

  31. Booth DJ, Kemmerer WT, Skinner DB: Acid clearing from distal esophagus. Arch Surg 96:731–734, 1988

    Google Scholar 

  32. Stanciu C, Bennet JR: Oesophageal acid clearing: One factor in the production of reflux esophagitis. Gut 15:852–857, 1974

    Google Scholar 

  33. Kahrilas PJ, Dodds WJ, Hogan WJ: Effect of peristaltic dysfunction on esophageal volume clearance. Gastroenterology 94:73–80, 1988

    Google Scholar 

  34. Behar J, Ramsby G: Gastric emptying and antral motility in reflux esophagitis. Effect of oral metoclopramide. Gastroenterology 74:253–256, 1978

    Google Scholar 

  35. Fink SM, Lange RC, McCallum RW: Effect of metoclopramide on normal and delayed gastric emptying in gastroesophageal reflux patients. Dig Dis Sic 28:1057–1061, 1983

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Digestive Motility Unit, Department of Surgery and Gastroenterology Service, Hospital Clinic i Provincial, University of Barcelona, c/Villarroel 170, 08036, Barcelona, Spain

    Luis Grande MD, Gloria Lacima MD, Emilio Ros MD, Juan Carlos García-Valdecasas MD, José Fuster MD, José Visa MD & Cristóbal Pera MD

Authors
  1. Luis Grande MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gloria Lacima MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emilio Ros MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Juan Carlos García-Valdecasas MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. José Fuster MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. José Visa MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Cristóbal Pera MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Supported in part by grant 87/1132, 89/631, and 90/505 from FISSS, Spanish Ministry of Health.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grande, L., Lacima, G., Ros, E. et al. Lack of effect of metoclopramide and domperidone on esophageal peristalsis and esophageal acid clearance in reflux esophagitis. Digest Dis Sci 37, 583–588 (1992). https://doi.org/10.1007/BF01307583

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01307583

Key Words

Search

Navigation