A study on the effects of clinical drugs on lower esophageal sphincter pressure. Particularly on the relation with clinical drugs

Abstract

Lower esophageal sphincter pressure (LESP) in man was measured by using a miniature semiconductor pressure sensor and the effects of clinical drugs on lower esophageal sphincter (LES) were examined. In total, 183 clinical cases were studied; 88 cases as controls, 38 esophagitis cases, 31 gastric ulcer cases, 21 duodenal ulcer cases, 4 liver cirrhosis cases and 1 scleroderma case. Drugs studied were pentagastrin, metoclopramide, domperidone, NaHCO3, maalox, cimetidine, secretin, glucagon, nifedipine, and nicardipine hydrochloride. There results obtained were as follows.Continuous intravenous drip infusion of pentagastrin (12μg/min) tentatively raises LESP. Also both metoclopramide and domperidone showed a tentative LESP-raising effect when administered either intravenously (10mg) or orally (10, 20mg) . The peak of the effect was 3-10 minutes after the intravenous injection and 20-30 minutes after the oral administration. The effect of oral administration lasted long and its effectiveness was as good as that of an intravenous injection. NaHCO3 and maalox also raised LESP tentatively. The ordinary dose of NaHCO3 (1.0g) or maalox (10ml) had the effect of raising LESP for approximately 30 minutes. LESP raising effect of intravenously injected cimetidine (200mg) was not clear. An intravenous injection of secretin (1u/kg) or glucagon (1.0mg) clearly lowered LESP. Also, orally administered nifedipine (10mg) or nicardipine hydrochloride (10mg) tentatively lowered LESP. LESP-lowering effect of nifedipine was tentatively inhibited by metoclopramide.