Effects of mosapride on secondary peristalsis in patients with ineffective esophageal motility. (December 2013)

• Record Type: Journal Article
• Authors: Chen, Chien-Lin; Yi, Chih-Hsun; Liu, Tso-Tsai; Orr, William C.
• Is Part Of: Scandinavian journal of gastroenterology. Volume 48:Number 12(2013)
• Page Start: 1363
• Page End: 1370
• Publication Date: 2013-12
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2013.840856
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Objective.</italic> </bold> Ineffective esophageal motility is frequently found in patients with gastroesophageal reflux diseases. Secondary peristalsis contributes to esophageal acid clearance. Mosapride improves gastrointestinal (GI) motility by acting on 5-hydroxytrypatamine<sub>4</sub> receptors. The authors aimed to evaluate the effect of mosapride on secondary peristalsis in patients with ineffective esophageal motility. <bold><italic>Material and methods.</italic></bold> After recording primary peristalsis baseline, secondary peristalsis was stimulated by slowly and rapidly injecting mid-esophageal air in 18 patients. Two separate experiments were randomly performed with 40 mg oral mosapride or placebo. <bold><italic>Results.</italic></bold> Mosapride had no effect on the threshold volume of secondary peristalsis during slow air distension (9.8 ± 0.97 vs. 10.2 ± 1.0 mL; <italic>p</italic> = 0.84), but decreased the threshold volume during rapid air distension (4.1 ± 0.2 vs. 4.6 ± 0.3 mL; <italic>p</italic> = 0.001). The efficiency of secondary peristalsis during rapid air distension increased with mosapride (70% [40–95%]) compared with placebo (60% [10–85%]; <italic>p</italic> = 0.0003). Mosapride had no effect on the amplitudes of distal pressure wave of secondary peristalsis during slow (94.3 ± 9 vs. 101.9 ± 9.1 mmHg; <italic>p</italic> = 0.63) or rapid air distension (89.3 ± 9 vs. 95.2 ± 8.3 mmHg; <italic>p</italic> = 0.24). <bold><italic>Conclusions.</italic></bold> Mosapride improves esophageal sensitivity of secondary peristalsis by abrupt air distension but has limited effect on the motor properties of secondary peristalsis in ineffective esophageal motility patients. Despite its well-known prokinetic effect, mosapride enhances the efficiency of secondary peristalsis in patients with ineffective esophageal motility through augmenting esophageal sensitivity instead of motility.</p> </abstract>