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01-04-2010 | Original Article—Alimentary Tract

The prokinetic effect of mosapride citrate combined with omeprazole therapy improves clinical symptoms and gastric emptying in PPI-resistant NERD patients with delayed gastric emptying

Authors: Seiji Futagami, Katsuhiko Iwakiri, Tomotaka Shindo, Tetsuro Kawagoe, Akane Horie, Mayumi Shimpuku, Yuriko Tanaka, Noriyuki Kawami, Katya Gudis, Choitsu Sakamoto

Published in: Journal of Gastroenterology | Issue 4/2010

Abstract

Background

Previous studies have shown that non-erosive reflux disease (NERD) patients are less sensitive to proton pump inhibitor (PPI) treatment than patients with erosive reflux disease. The aim of this study was to investigate whether treatment with prokinetics in addition to omeprazole therapy would improve clinical symptoms, gastric emptying and esophageal peristalsis in PPI-resistant NERD patients with or without delayed gastric emptying.

Methods

Subjects were 64 consecutive patients presenting with typical symptoms of PPl-resistant NERD (n = 44) and 20 healthy volunteers. PPI-resistant NERD patients underwent mosapride citrate (15 mg/day) and omeprazole (20 mg/day) co-therapy for 12 weeks. We evaluated the clinical symptoms as well as gastric emptying and esophageal manometry before and after combined therapy. We measured both acylated- and des-acylated plasma ghrelin levels by the ELISA method. The primary endopoint was to investigate whether co-administration of mosapride citrate and omeprazole would improve clinical symptoms and gastric emptying in PPI-resistant NERD patients with delayed gastric emptying.

Results

T_max value in PPI-resistant NERD patients was significantly higher than in healthy volunteers. Combination therapy with the prokinetic agent mosapride citrate and omeprazole significantly improved reflux symptoms and T_max value in T_max > 65 min NERD patients. Co-therapy also significantly reduced des-acylated-ghrelin levels in NERD patients with delayed gastric emptying.

Conclusions

Administration of mosapride citrate in addition to omeprazole improved gastro-esophageal reflux and gastric emptying in PPI-resistant NERD patients with delayed gastric emptying.

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Title: The prokinetic effect of mosapride citrate combined with omeprazole therapy improves clinical symptoms and gastric emptying in PPI-resistant NERD patients with delayed gastric emptying
Authors: Seiji Futagami
Katsuhiko Iwakiri
Tomotaka Shindo
Tetsuro Kawagoe
Akane Horie
Mayumi Shimpuku
Yuriko Tanaka
Noriyuki Kawami
Katya Gudis
Choitsu Sakamoto
Publication date: 01-04-2010
Publisher: Springer Japan
Published in: Journal of Gastroenterology / Issue 4/2010
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI: https://doi.org/10.1007/s00535-009-0173-0

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Background

Methods

Results

Conclusions

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