Document Detail


Metoclopramide response in patients with early diffuse systemic sclerosis. Effects on esophageal motility abnormalities.
MedLine Citation:
PMID:  16173247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the metoclopramide response in patients with early diffuse systemic sclerosis (dSSc) and the acute effects of intravenous (IV) metoclopramide on the lower esophageal sphincter (LES). METHODS: Twenty-one patients with early dSSc (mean age 41.4 +/- 9.8 yrs., mean disease duration 2.47 +/- 0.75 yrs.) were prospectively evaluated. Six patients with late dSSc (mean age 52.6 +/- 9.1 yrs., mean disease duration 9.5 +/- 2.5 yrs.) were used as control group. All underwent solid-state esophageal manometry at rest and 15 minutes later received 10 mg of metoclopramide in an intravenous single bolus. RESULTS: We found that the mean LES pressures measured by the station pull-through technique significantly increased in both early and late dSSc patients after metoclopramide administration (p < 0.05). While early dSSc patients did improve the mean residual pressures (p < 0.05), late dSSc patients did not (p > 0.05). In the esophageal body (EB), the mean contractions amplitude at 18, 13, 8, and 3 cm above the LES was < 20 mm Hg for both groups. However, peristaltic contraction velocitiy was significantly higher in early dSSc patients (< 0.05) than in that with late dSSc (p > 0.05). Our study did not show any major differences when comparing both groups. No side effects were seen. CONCLUSIONS: The results of our study show that metoclopramide may improve LES pressures in patients with early and late dSS. Metoclopramide improve the mean residual pressure in patients with early dSSc, but not in late dSSc patients. Although esophageal contractions amplitude were significantly improved, they did not achieve a pressure > 20 mm Hg. Because metoclopramide can be used orally, it may mitigate both dysphagia and heartburn.
Authors:
U Mercado; R Arroyo de Anda; L Avendaño; R Araiza-Casillas; M Avendaño-Reyes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental rheumatology     Volume:  23     ISSN:  0392-856X     ISO Abbreviation:  Clin. Exp. Rheumatol.     Publication Date:    2005 Sep-Oct
Date Detail:
Created Date:  2005-09-21     Completed Date:  2005-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8308521     Medline TA:  Clin Exp Rheumatol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  685-8     Citation Subset:  IM    
Affiliation:
Hospital General Mexicali, ISESALUD and Universidad Autonoma de Baja California, Mexicali, Mexico. ulisesmercado@uabc.mx
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MeSH Terms
Descriptor/Qualifier:
Adult
Esophageal Motility Disorders / drug therapy*,  etiology
Esophageal Sphincter, Lower / drug effects*
Female
Gastrointestinal Agents / administration & dosage*
Humans
Infusions, Intravenous
Male
Metoclopramide / administration & dosage*
Middle Aged
Scleroderma, Systemic / complications*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents; 364-62-5/Metoclopramide

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


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