The effect of cholecystokinin antagonism on postprandial lower oesophageal sphincter function in asymptomatic volunteers and patients with reflux disease.
Aliment Pharmacol Ther
; 15(9): 1357-64, 2001 Sep.
Article
em En
| MEDLINE
| ID: mdl-11552906
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.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Proglumida
/
Colecistocinina
/
Refluxo Gastroesofágico
/
Período Pós-Prandial
/
Junção Esofagogástrica
/
Antagonistas de Hormônios
Tipo de estudo:
Clinical_trials
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Aliment Pharmacol Ther
Assunto da revista:
FARMACOLOGIA
/
GASTROENTEROLOGIA
/
TERAPIA POR MEDICAMENTOS
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
Reino Unido