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Effect of atropine on gastro-oesophageal reflux and transient lower oesophageal sphincter relaxations in patients with gastro-oesophageal reflux disease.
Gut. 1998 Jul; 43(1):12-6.Gut

Abstract

BACKGROUND

Atropine reduces the rate of reflux episodes in normal subjects by inhibition of transient lower oesophageal sphincter (LOS) relaxations. The aim of this study was to investigate the effect of atropine on the rate and mechanisms of reflux in patients with reflux disease.

METHODS

Oesophageal motility and pH were recorded for one hour after a meal in 15 patients with reflux disease. On separate days, atropine (15 micrograms/kg bolus intravenously, 4 micrograms/kg/h infusion) or saline were given and maintained for the recording period.

RESULTS

Atropine significantly reduced basal LOS pressure from 7.1 (2.2) to 2.9 (1.3) mm Hg (mean (SEM)). Atropine also reduced the rate of reflux episodes from 5.0 (2.0-8.75) to 1.0 (0-6.25) per hour (median (interquartile range)) largely because of a decrease in the rate of transient LOS relaxations from 2.0 (0-4.75) to 0 (0-0) per hour and abolition of reflux during swallow induced LOS relaxation. There was no change in the rate of reflux episodes because of absent basal LOS pressure.

CONCLUSIONS

Atropine inhibits reflux in patients with reflux disease largely by inhibition of transient LOS relaxations and swallow induced LOS relaxation. These findings suggest that pharmacological control of reflux through control of transient LOS relaxations is possible in patients with reflux disease.

Authors+Show Affiliations

Department of Gastrointestinal Medicine, Royal Adelaide Hospital, Australia.No 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

9771399

Citation

Lidums, I, et al. "Effect of Atropine On Gastro-oesophageal Reflux and Transient Lower Oesophageal Sphincter Relaxations in Patients With Gastro-oesophageal Reflux Disease." Gut, vol. 43, no. 1, 1998, pp. 12-6.
Lidums I, Checklin H, Mittal RK, et al. Effect of atropine on gastro-oesophageal reflux and transient lower oesophageal sphincter relaxations in patients with gastro-oesophageal reflux disease. Gut. 1998;43(1):12-6.
Lidums, I., Checklin, H., Mittal, R. K., & Holloway, R. H. (1998). Effect of atropine on gastro-oesophageal reflux and transient lower oesophageal sphincter relaxations in patients with gastro-oesophageal reflux disease. Gut, 43(1), 12-6.
Lidums I, et al. Effect of Atropine On Gastro-oesophageal Reflux and Transient Lower Oesophageal Sphincter Relaxations in Patients With Gastro-oesophageal Reflux Disease. Gut. 1998;43(1):12-6. PubMed PMID: 9771399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of atropine on gastro-oesophageal reflux and transient lower oesophageal sphincter relaxations in patients with gastro-oesophageal reflux disease. AU - Lidums,I, AU - Checklin,H, AU - Mittal,R K, AU - Holloway,R H, PY - 1998/10/15/pubmed PY - 1998/10/15/medline PY - 1998/10/15/entrez SP - 12 EP - 6 JF - Gut JO - Gut VL - 43 IS - 1 N2 - BACKGROUND: Atropine reduces the rate of reflux episodes in normal subjects by inhibition of transient lower oesophageal sphincter (LOS) relaxations. The aim of this study was to investigate the effect of atropine on the rate and mechanisms of reflux in patients with reflux disease. METHODS: Oesophageal motility and pH were recorded for one hour after a meal in 15 patients with reflux disease. On separate days, atropine (15 micrograms/kg bolus intravenously, 4 micrograms/kg/h infusion) or saline were given and maintained for the recording period. RESULTS: Atropine significantly reduced basal LOS pressure from 7.1 (2.2) to 2.9 (1.3) mm Hg (mean (SEM)). Atropine also reduced the rate of reflux episodes from 5.0 (2.0-8.75) to 1.0 (0-6.25) per hour (median (interquartile range)) largely because of a decrease in the rate of transient LOS relaxations from 2.0 (0-4.75) to 0 (0-0) per hour and abolition of reflux during swallow induced LOS relaxation. There was no change in the rate of reflux episodes because of absent basal LOS pressure. CONCLUSIONS: Atropine inhibits reflux in patients with reflux disease largely by inhibition of transient LOS relaxations and swallow induced LOS relaxation. These findings suggest that pharmacological control of reflux through control of transient LOS relaxations is possible in patients with reflux disease. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/9771399/Effect_of_atropine_on_gastro_oesophageal_reflux_and_transient_lower_oesophageal_sphincter_relaxations_in_patients_with_gastro_oesophageal_reflux_disease_ L2 - https://gut.bmj.com/lookup/pmidlookup?view=long&pmid=9771399 DB - PRIME DP - Unbound Medicine ER -