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Effect of sumatriptan, a 5HT1 agonist, on the frequency of transient lower esophageal sphincter relaxations and gastroesophageal reflux in healthy subjects.
Am J Gastroenterol. 1999 Nov; 94(11):3158-64.AJ

Abstract

OBJECTIVE

Meals increase the rate of transient lower esophageal sphincter (LES) relaxations, in part by gastric distension. The 5HT1 agonist sumatriptan reduces fasting fundic tone, prolongs the meal-induced fundic relaxation, and delays gastric emptying. We therefore hypothesized that sumatriptan might have a significant effect on the rate of postprandial transient LES relaxations and gastroesophageal reflux. We aimed to study the effect of sumatriptan on postprandial transient LES relaxations and reflux in healthy subjects.

METHODS

Esophageal manometry and pH monitoring were performed in 13 healthy volunteers for 30 min before and 90 min after a semiliquid meal (790 kcal). Sumatriptan 6 mg subcutaneous (s.c.) or s.c. placebo were administered on separate days 30 min after the meal.

RESULTS

Sumatriptan significantly increased postprandial LES pressure from 11.0 +/- 1.2 mm Hg to 17.6 +/- 1.2 mm Hg (p < 0.05). However, reflux events were not diminished. In the contrary, reflux was more frequent after sumatriptan than after placebo (3 [1.5-4.5]/30 min vs 2 [0-3]/30 min, p < 0.05). Transient LES relaxations were more frequent after sumatriptan, particularly in the second 30-min period after drug administration (3 [2.5-5]/30 min vs 2 [1.5-2]/30 min, p < 0.05).

CONCLUSIONS

Sumatriptan prevents the natural decay in rate of transient LES relaxations that occurs after a meal and favors the occurrence of gastroesophageal reflux despite increasing LES pressure. The sustained postprandial high rate of transient LES relaxations after sumatriptan may be a consequence of a prolonged fundus relaxation and retention of meal in the proximal stomach.

Authors+Show Affiliations

Centre for Gastroenterological Research, University of Leuven, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10566707

Citation

Sifrim, D, et al. "Effect of Sumatriptan, a 5HT1 Agonist, On the Frequency of Transient Lower Esophageal Sphincter Relaxations and Gastroesophageal Reflux in Healthy Subjects." The American Journal of Gastroenterology, vol. 94, no. 11, 1999, pp. 3158-64.
Sifrim D, Holloway RH, Tack J, et al. Effect of sumatriptan, a 5HT1 agonist, on the frequency of transient lower esophageal sphincter relaxations and gastroesophageal reflux in healthy subjects. Am J Gastroenterol. 1999;94(11):3158-64.
Sifrim, D., Holloway, R. H., Tack, J., Zelter, A., Missotten, T., Coulie, B., & Janssens, J. (1999). Effect of sumatriptan, a 5HT1 agonist, on the frequency of transient lower esophageal sphincter relaxations and gastroesophageal reflux in healthy subjects. The American Journal of Gastroenterology, 94(11), 3158-64.
Sifrim D, et al. Effect of Sumatriptan, a 5HT1 Agonist, On the Frequency of Transient Lower Esophageal Sphincter Relaxations and Gastroesophageal Reflux in Healthy Subjects. Am J Gastroenterol. 1999;94(11):3158-64. PubMed PMID: 10566707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of sumatriptan, a 5HT1 agonist, on the frequency of transient lower esophageal sphincter relaxations and gastroesophageal reflux in healthy subjects. AU - Sifrim,D, AU - Holloway,R H, AU - Tack,J, AU - Zelter,A, AU - Missotten,T, AU - Coulie,B, AU - Janssens,J, PY - 1999/11/24/pubmed PY - 1999/11/24/medline PY - 1999/11/24/entrez SP - 3158 EP - 64 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 94 IS - 11 N2 - OBJECTIVE: Meals increase the rate of transient lower esophageal sphincter (LES) relaxations, in part by gastric distension. The 5HT1 agonist sumatriptan reduces fasting fundic tone, prolongs the meal-induced fundic relaxation, and delays gastric emptying. We therefore hypothesized that sumatriptan might have a significant effect on the rate of postprandial transient LES relaxations and gastroesophageal reflux. We aimed to study the effect of sumatriptan on postprandial transient LES relaxations and reflux in healthy subjects. METHODS: Esophageal manometry and pH monitoring were performed in 13 healthy volunteers for 30 min before and 90 min after a semiliquid meal (790 kcal). Sumatriptan 6 mg subcutaneous (s.c.) or s.c. placebo were administered on separate days 30 min after the meal. RESULTS: Sumatriptan significantly increased postprandial LES pressure from 11.0 +/- 1.2 mm Hg to 17.6 +/- 1.2 mm Hg (p < 0.05). However, reflux events were not diminished. In the contrary, reflux was more frequent after sumatriptan than after placebo (3 [1.5-4.5]/30 min vs 2 [0-3]/30 min, p < 0.05). Transient LES relaxations were more frequent after sumatriptan, particularly in the second 30-min period after drug administration (3 [2.5-5]/30 min vs 2 [1.5-2]/30 min, p < 0.05). CONCLUSIONS: Sumatriptan prevents the natural decay in rate of transient LES relaxations that occurs after a meal and favors the occurrence of gastroesophageal reflux despite increasing LES pressure. The sustained postprandial high rate of transient LES relaxations after sumatriptan may be a consequence of a prolonged fundus relaxation and retention of meal in the proximal stomach. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/10566707/Effect_of_sumatriptan_a_5HT1_agonist_on_the_frequency_of_transient_lower_esophageal_sphincter_relaxations_and_gastroesophageal_reflux_in_healthy_subjects_ L2 - https://Insights.ovid.com/pubmed?pmid=10566707 DB - PRIME DP - Unbound Medicine ER -