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Effect of cisapride on nocturnal transient lower oesophageal sphincter relaxations and nocturnal gastro-oesophageal reflux in patients with oesophagitis: a double-blind, placebo-controlled study.
Aliment Pharmacol Ther 2002; 16(4):743-7AP

Abstract

AIM

To investigate the effect of cisapride, a selective 5-hydroxytryptamine-4 receptor agonist, on the frequency of nocturnal transient lower oesophageal sphincter relaxations and oesophageal acid exposure in patients with gastro-oesophageal reflux disease.

METHODS

In a double-blind, placebo-controlled study, 10 patients with gastro-oesophageal reflux disease (six male and four female; mean age, 54 +/- 10.4 years) were randomly assigned to 5-day treatments with cisapride, 10 mg q.d.s., or placebo, separated by a 2-day washout period before the treatment crossover. Sleep stages, lower oesophageal sphincter tone and oesophageal pH were monitored overnight at the end of each treatment regimen. Gastric emptying was assessed before treatment.

RESULTS

Cisapride decreased the frequency of transient lower oesophageal sphincter relaxations during sleep (1.2 +/- 0.2/h vs. 2.7 +/- 0.5/h with placebo; P=0.004) and oesophageal acid exposure (17.2 +/- 9.9% with placebo vs. 7.2 +/- 4.2% with cisapride; P=0.4). Cisapride increased lower oesophageal sphincter tone from 12.7 +/- 2.8 mmHg with placebo to 16.9 +/- 3.9 mmHg (P=0.03), and decreased heartburn episodes and antacid consumption. All patients had normal gastric retention data over 4 h.

CONCLUSIONS

In patients with gastro-oesophageal reflux disease, cisapride significantly decreased the frequency of transient lower oesophageal sphincter relaxations during sleep and increased lower oesophageal sphincter pressure without changing gastric emptying. We hypothesize, therefore, that 5-hydroxytryptamine-4 mechanisms are important in the control of transient lower oesophageal sphincter relaxations in humans.

Authors+Show Affiliations

Division of Gastroenterology, University of Kansas Medical Center, Kansas City, KS 66160, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

11929392

Citation

Pehlivanov, N, et al. "Effect of Cisapride On Nocturnal Transient Lower Oesophageal Sphincter Relaxations and Nocturnal Gastro-oesophageal Reflux in Patients With Oesophagitis: a Double-blind, Placebo-controlled Study." Alimentary Pharmacology & Therapeutics, vol. 16, no. 4, 2002, pp. 743-7.
Pehlivanov N, Sarosiek I, Whitman R, et al. Effect of cisapride on nocturnal transient lower oesophageal sphincter relaxations and nocturnal gastro-oesophageal reflux in patients with oesophagitis: a double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2002;16(4):743-7.
Pehlivanov, N., Sarosiek, I., Whitman, R., Olyaee, M., & McCallum, R. (2002). Effect of cisapride on nocturnal transient lower oesophageal sphincter relaxations and nocturnal gastro-oesophageal reflux in patients with oesophagitis: a double-blind, placebo-controlled study. Alimentary Pharmacology & Therapeutics, 16(4), pp. 743-7.
Pehlivanov N, et al. Effect of Cisapride On Nocturnal Transient Lower Oesophageal Sphincter Relaxations and Nocturnal Gastro-oesophageal Reflux in Patients With Oesophagitis: a Double-blind, Placebo-controlled Study. Aliment Pharmacol Ther. 2002;16(4):743-7. PubMed PMID: 11929392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of cisapride on nocturnal transient lower oesophageal sphincter relaxations and nocturnal gastro-oesophageal reflux in patients with oesophagitis: a double-blind, placebo-controlled study. AU - Pehlivanov,N, AU - Sarosiek,I, AU - Whitman,R, AU - Olyaee,M, AU - McCallum,R, PY - 2002/4/4/pubmed PY - 2002/9/7/medline PY - 2002/4/4/entrez SP - 743 EP - 7 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 16 IS - 4 N2 - AIM: To investigate the effect of cisapride, a selective 5-hydroxytryptamine-4 receptor agonist, on the frequency of nocturnal transient lower oesophageal sphincter relaxations and oesophageal acid exposure in patients with gastro-oesophageal reflux disease. METHODS: In a double-blind, placebo-controlled study, 10 patients with gastro-oesophageal reflux disease (six male and four female; mean age, 54 +/- 10.4 years) were randomly assigned to 5-day treatments with cisapride, 10 mg q.d.s., or placebo, separated by a 2-day washout period before the treatment crossover. Sleep stages, lower oesophageal sphincter tone and oesophageal pH were monitored overnight at the end of each treatment regimen. Gastric emptying was assessed before treatment. RESULTS: Cisapride decreased the frequency of transient lower oesophageal sphincter relaxations during sleep (1.2 +/- 0.2/h vs. 2.7 +/- 0.5/h with placebo; P=0.004) and oesophageal acid exposure (17.2 +/- 9.9% with placebo vs. 7.2 +/- 4.2% with cisapride; P=0.4). Cisapride increased lower oesophageal sphincter tone from 12.7 +/- 2.8 mmHg with placebo to 16.9 +/- 3.9 mmHg (P=0.03), and decreased heartburn episodes and antacid consumption. All patients had normal gastric retention data over 4 h. CONCLUSIONS: In patients with gastro-oesophageal reflux disease, cisapride significantly decreased the frequency of transient lower oesophageal sphincter relaxations during sleep and increased lower oesophageal sphincter pressure without changing gastric emptying. We hypothesize, therefore, that 5-hydroxytryptamine-4 mechanisms are important in the control of transient lower oesophageal sphincter relaxations in humans. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/11929392/Effect_of_cisapride_on_nocturnal_transient_lower_oesophageal_sphincter_relaxations_and_nocturnal_gastro_oesophageal_reflux_in_patients_with_oesophagitis:_a_double_blind_placebo_controlled_study_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=2002&volume=16&issue=4&spage=743 DB - PRIME DP - Unbound Medicine ER -