Document Detail


Effect of sumatriptan, a 5HT1 agonist, on the frequency of transient lower esophageal sphincter relaxations and gastroesophageal reflux in healthy subjects.
MedLine Citation:
PMID:  10566707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Meals increase the rate of transient lower esophageal sphincter (LES) relaxations, in part by gastric distension. The 5HT1 agonist sumatriptan reduces fasting fundic tone, prolongs the meal-induced fundic relaxation, and delays gastric emptying. We therefore hypothesized that sumatriptan might have a significant effect on the rate of postprandial transient LES relaxations and gastroesophageal reflux. We aimed to study the effect of sumatriptan on postprandial transient LES relaxations and reflux in healthy subjects. METHODS: Esophageal manometry and pH monitoring were performed in 13 healthy volunteers for 30 min before and 90 min after a semiliquid meal (790 kcal). Sumatriptan 6 mg subcutaneous (s.c.) or s.c. placebo were administered on separate days 30 min after the meal. RESULTS: Sumatriptan significantly increased postprandial LES pressure from 11.0 +/- 1.2 mm Hg to 17.6 +/- 1.2 mm Hg (p < 0.05). However, reflux events were not diminished. In the contrary, reflux was more frequent after sumatriptan than after placebo (3 [1.5-4.5]/30 min vs 2 [0-3]/30 min, p < 0.05). Transient LES relaxations were more frequent after sumatriptan, particularly in the second 30-min period after drug administration (3 [2.5-5]/30 min vs 2 [1.5-2]/30 min, p < 0.05). CONCLUSIONS: Sumatriptan prevents the natural decay in rate of transient LES relaxations that occurs after a meal and favors the occurrence of gastroesophageal reflux despite increasing LES pressure. The sustained postprandial high rate of transient LES relaxations after sumatriptan may be a consequence of a prolonged fundus relaxation and retention of meal in the proximal stomach.
Authors:
D Sifrim; R H Holloway; J Tack; A Zelter; T Missotten; B Coulie; J Janssens
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  94     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1999 Nov 
Date Detail:
Created Date:  1999-11-30     Completed Date:  1999-11-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  3158-64     Citation Subset:  IM    
Affiliation:
Centre for Gastroenterological Research, University of Leuven, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Eating / physiology
Esophagogastric Junction / drug effects*
Female
Gastric Emptying / drug effects,  physiology
Gastric Fundus / drug effects,  physiopathology
Gastroesophageal Reflux / drug therapy*,  physiopathology
Humans
Hydrogen-Ion Concentration
Injections, Subcutaneous
Male
Muscle Relaxation / drug effects
Placebos
Pressure
Serotonin Agonists / administration & dosage,  therapeutic use*
Single-Blind Method
Stomach / drug effects,  physiopathology
Sumatriptan / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Placebos; 0/Serotonin Agonists; 103628-46-2/Sumatriptan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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