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The effect of cholecystokinin antagonism on postprandial lower oesophageal sphincter function in asymptomatic volunteers and patients with reflux disease.
Aliment Pharmacol Ther. 2001 Sep; 15(9):1357-64.AP

Abstract

BACKGROUND

Postprandial acid reflux is thought to be mediated by the increase in transient lower oesophageal sphincter relaxations (TLOSR) frequency and fall in lower oesophageal sphincter (LOS) pressure seen after ingestion of a meal. Studies in animals and healthy volunteers suggest that cholecystokinin (CCK) may play a role.

AIM

To study the role of CCK in postprandial LOS function using the CCK antagonist loxiglumide.

SUBJECTS

10 asymptomatic volunteers (7 male, 20-29 years) and 9 patients with symptomatic gastro-oesophageal reflux (4 male, 33-66 years).

METHODS

Oesophageal, LOS and gastric pressure and oesophageal pH readings were recorded for 1 h before and 2 h after intragastric infusion of a 200 kCal, 300 mL long chain triglyceride meal. Each subject underwent two studies and received intravenous loxiglumide or placebo infusion in randomized order.

RESULTS

During placebo infusion, postprandial LOS pressure fell [volunteers: 17 (9-31) to 7 (1-19) mmHg (P < 0.01), patients: 15 (6-26) to 9 (2-21) mmHg (P=0.02)] and TLOSR frequency increased [volunteers: 0 (0-1) to 2 (0-7) per hour (P=0.01), patients: 0 (0-3) to 2 (0-10) per hour (P=0.03)]. Loxiglumide infusion attenuated the postprandial fall in LOS pressure and the postprandial increase in TLOSR frequency [volunteers: 0 (0-3) per hour (P=0.04 vs. placebo), patients: 0 (0-2) per hour (P=0.03 vs. placebo)], but it had only modest effects on postprandial acid exposure [volunteers: placebo 45 (0-1725) vs. loxiglumide 0 (0-443) seconds (N.S.), patients: placebo 60 (0-3442) seconds vs. loxiglumide 31 (0-1472) seconds (N.S.)].

CONCLUSIONS

Loxiglumide inhibits TLOSR and attenuates the fall in LOS pressure following a meal, but has only modest effects on postprandial gastro-oesophageal acid reflux.

Authors+Show Affiliations

Department of Gastroenterology, Northern General Hospital, Sheffield, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11552906

Citation

Trudgill, N J., et al. "The Effect of Cholecystokinin Antagonism On Postprandial Lower Oesophageal Sphincter Function in Asymptomatic Volunteers and Patients With Reflux Disease." Alimentary Pharmacology & Therapeutics, vol. 15, no. 9, 2001, pp. 1357-64.
Trudgill NJ, Hussain FN, Moustafa M, et al. The effect of cholecystokinin antagonism on postprandial lower oesophageal sphincter function in asymptomatic volunteers and patients with reflux disease. Aliment Pharmacol Ther. 2001;15(9):1357-64.
Trudgill, N. J., Hussain, F. N., Moustafa, M., Ajjan, R., D'Amato, M., & Riley, S. A. (2001). The effect of cholecystokinin antagonism on postprandial lower oesophageal sphincter function in asymptomatic volunteers and patients with reflux disease. Alimentary Pharmacology & Therapeutics, 15(9), 1357-64.
Trudgill NJ, et al. The Effect of Cholecystokinin Antagonism On Postprandial Lower Oesophageal Sphincter Function in Asymptomatic Volunteers and Patients With Reflux Disease. Aliment Pharmacol Ther. 2001;15(9):1357-64. PubMed PMID: 11552906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of cholecystokinin antagonism on postprandial lower oesophageal sphincter function in asymptomatic volunteers and patients with reflux disease. AU - Trudgill,N J, AU - Hussain,F N, AU - Moustafa,M, AU - Ajjan,R, AU - D'Amato,M, AU - Riley,S A, PY - 2001/9/13/pubmed PY - 2001/10/26/medline PY - 2001/9/13/entrez SP - 1357 EP - 64 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 15 IS - 9 N2 - BACKGROUND: Postprandial acid reflux is thought to be mediated by the increase in transient lower oesophageal sphincter relaxations (TLOSR) frequency and fall in lower oesophageal sphincter (LOS) pressure seen after ingestion of a meal. Studies in animals and healthy volunteers suggest that cholecystokinin (CCK) may play a role. AIM: To study the role of CCK in postprandial LOS function using the CCK antagonist loxiglumide. SUBJECTS: 10 asymptomatic volunteers (7 male, 20-29 years) and 9 patients with symptomatic gastro-oesophageal reflux (4 male, 33-66 years). METHODS: Oesophageal, LOS and gastric pressure and oesophageal pH readings were recorded for 1 h before and 2 h after intragastric infusion of a 200 kCal, 300 mL long chain triglyceride meal. Each subject underwent two studies and received intravenous loxiglumide or placebo infusion in randomized order. RESULTS: During placebo infusion, postprandial LOS pressure fell [volunteers: 17 (9-31) to 7 (1-19) mmHg (P < 0.01), patients: 15 (6-26) to 9 (2-21) mmHg (P=0.02)] and TLOSR frequency increased [volunteers: 0 (0-1) to 2 (0-7) per hour (P=0.01), patients: 0 (0-3) to 2 (0-10) per hour (P=0.03)]. Loxiglumide infusion attenuated the postprandial fall in LOS pressure and the postprandial increase in TLOSR frequency [volunteers: 0 (0-3) per hour (P=0.04 vs. placebo), patients: 0 (0-2) per hour (P=0.03 vs. placebo)], but it had only modest effects on postprandial acid exposure [volunteers: placebo 45 (0-1725) vs. loxiglumide 0 (0-443) seconds (N.S.), patients: placebo 60 (0-3442) seconds vs. loxiglumide 31 (0-1472) seconds (N.S.)]. CONCLUSIONS: Loxiglumide inhibits TLOSR and attenuates the fall in LOS pressure following a meal, but has only modest effects on postprandial gastro-oesophageal acid reflux. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/11552906/The_effect_of_cholecystokinin_antagonism_on_postprandial_lower_oesophageal_sphincter_function_in_asymptomatic_volunteers_and_patients_with_reflux_disease_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0269-2813&amp;date=2001&amp;volume=15&amp;issue=9&amp;spage=1357 DB - PRIME DP - Unbound Medicine ER -