Document Detail

Erythromycin strengthens the defective lower esophageal sphincter in patients with gastroesophageal reflux disease.
MedLine Citation:
PMID:  8311129     Owner:  NLM     Status:  MEDLINE    
Motilin induces phase III activity of the gastrointestinal tract. Erythromycin has a motilin-like effect on the stomach and significantly increases the lower esophageal sphincter (LES) pressure in normal volunteers. This investigation was performed to evaluate the effects of erythromycin on esophageal function in patients with gastroesophageal reflux disease (GERD). Esophageal manometry was performed in 10 GERD patients before and after intravenous infusion of 500 mg of erythromycin. Values are expressed as mean +/- SEM. LES pressure increased from 13.9 +/- 2.9 mm Hg at baseline to 28.9 +/- 3.6 mm Hg after infusion of erythromycin (p < 0.01). The duration of contractions in the proximal, middle, and distal esophagus was significantly prolonged from 3.5 +/- 0.4 seconds, 3.8 +/- 0.4 seconds, and 4.1 +/- 0.5 seconds to 4.2 +/- 0.2 seconds, 4.6 +/- 0.5 seconds, and 5.6 +/- 0.6 seconds, respectively, after infusion of erythromycin (p < 0.05 for each comparison). Erythromycin did not effect esophageal body contraction amplitude or velocity, or the upper esophageal sphincter. Serum motilin decreased slightly after the administration of erythromycin. We concluded the following: (1) Erythromycin profoundly stimulates the defective LES in patients with GERD. This appears to be a direct motilin agonist-like effect rather than being mediated by release of endogenous motilin. (2) Erythromycin has less effect on the esophageal body, although it does prolong the duration of esophageal contractions.
A Pennathur; A Tran; M Cioppi; J Fayad; G L Sieren; A G Little
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  167     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-03-17     Completed Date:  1994-03-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  169-72; discussion 172-3     Citation Subset:  AIM; IM    
Department of Surgery, University of Nevada School of Medicine, Las Vegas.
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MeSH Terms
Erythromycin / pharmacology*
Esophagogastric Junction / drug effects*,  physiology
Gastroesophageal Reflux / physiopathology*
Middle Aged
Motilin / drug effects,  physiology*
Myoelectric Complex, Migrating / drug effects
Peristalsis / drug effects
Stimulation, Chemical
Time Factors
Reg. No./Substance:
114-07-8/Erythromycin; 52906-92-0/Motilin

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

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