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Does the addition of a prokinetic to proton pump inhibitor therapy help reduce duodenogastro-oesophageal reflux in patients with Barrett's oesophagus?
Eur J Gastroenterol Hepatol 2003; 15(3):305-12EJ

Abstract

OBJECTIVE

The metaplastic change of Barrett's oesophagus is linked to both acid and duodenal reflux together with impaired motility. Proton pump inhibitors (PPI) reduce acid reflux, but no treatment is available that reduces duodenogastro-oesophageal reflux (DGOR). The aim of this study was to investigate whether adding a prokinetic to PPI treatment could improve oesophageal motility and subsequently reduce reflux.

METHODS

Two groups of patients with Barrett's oesophagus on PPI therapy (prokinetic, n = 12; placebo, n = 11) were investigated. At visit 1, ambulatory oesophageal manometry was performed, and peristaltic and simultaneous wave percentage and characteristics were measured. DGOR and pH measurements were also performed. After treatment with either the prokinetic cisapride or placebo, all investigations were repeated (visit 2). Analysis of covariance and Spearman's correlation coefficients of changes from visit 1 to visit 2 were used to compare data.

RESULTS

There was no significant difference between the two groups with respect to DGOR, DGOR characteristics, or the percentage of peristalsis and simultaneous waves and their characteristics. There was no correlation between DGOR and motility changes. Although no significant differences existed between acid reflux in the two groups, five patients with high supine acid reflux showed a significant reduction after treatment with cisapride.

CONCLUSIONS

Addition of cisapride to PPI treatment does not appear to improve oesophageal motility or reduce DGOR in patients with Barrett's oesophagus.

Authors+Show Affiliations

Academic Surgical Unit, University of Sheffield, UK. a.smythe@sheffield.ac.ukNo 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

12610326

Citation

Smythe, Anne, et al. "Does the Addition of a Prokinetic to Proton Pump Inhibitor Therapy Help Reduce Duodenogastro-oesophageal Reflux in Patients With Barrett's Oesophagus?" European Journal of Gastroenterology & Hepatology, vol. 15, no. 3, 2003, pp. 305-12.
Smythe A, Bird NC, Troy GP, et al. Does the addition of a prokinetic to proton pump inhibitor therapy help reduce duodenogastro-oesophageal reflux in patients with Barrett's oesophagus? Eur J Gastroenterol Hepatol. 2003;15(3):305-12.
Smythe, A., Bird, N. C., Troy, G. P., Ackroyd, R., & Johnson, A. G. (2003). Does the addition of a prokinetic to proton pump inhibitor therapy help reduce duodenogastro-oesophageal reflux in patients with Barrett's oesophagus? European Journal of Gastroenterology & Hepatology, 15(3), pp. 305-12.
Smythe A, et al. Does the Addition of a Prokinetic to Proton Pump Inhibitor Therapy Help Reduce Duodenogastro-oesophageal Reflux in Patients With Barrett's Oesophagus. Eur J Gastroenterol Hepatol. 2003;15(3):305-12. PubMed PMID: 12610326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does the addition of a prokinetic to proton pump inhibitor therapy help reduce duodenogastro-oesophageal reflux in patients with Barrett's oesophagus? AU - Smythe,Anne, AU - Bird,Nigel C, AU - Troy,Gill P, AU - Ackroyd,Roger, AU - Johnson,Alan G, PY - 2003/3/1/pubmed PY - 2003/5/20/medline PY - 2003/3/1/entrez SP - 305 EP - 12 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 15 IS - 3 N2 - OBJECTIVE: The metaplastic change of Barrett's oesophagus is linked to both acid and duodenal reflux together with impaired motility. Proton pump inhibitors (PPI) reduce acid reflux, but no treatment is available that reduces duodenogastro-oesophageal reflux (DGOR). The aim of this study was to investigate whether adding a prokinetic to PPI treatment could improve oesophageal motility and subsequently reduce reflux. METHODS: Two groups of patients with Barrett's oesophagus on PPI therapy (prokinetic, n = 12; placebo, n = 11) were investigated. At visit 1, ambulatory oesophageal manometry was performed, and peristaltic and simultaneous wave percentage and characteristics were measured. DGOR and pH measurements were also performed. After treatment with either the prokinetic cisapride or placebo, all investigations were repeated (visit 2). Analysis of covariance and Spearman's correlation coefficients of changes from visit 1 to visit 2 were used to compare data. RESULTS: There was no significant difference between the two groups with respect to DGOR, DGOR characteristics, or the percentage of peristalsis and simultaneous waves and their characteristics. There was no correlation between DGOR and motility changes. Although no significant differences existed between acid reflux in the two groups, five patients with high supine acid reflux showed a significant reduction after treatment with cisapride. CONCLUSIONS: Addition of cisapride to PPI treatment does not appear to improve oesophageal motility or reduce DGOR in patients with Barrett's oesophagus. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/12610326/Does_the_addition_of_a_prokinetic_to_proton_pump_inhibitor_therapy_help_reduce_duodenogastro_oesophageal_reflux_in_patients_with_Barrett's_oesophagus L2 - http://Insights.ovid.com/pubmed?pmid=12610326 DB - PRIME DP - Unbound Medicine ER -