Healing and prevention of relapse reflux esophagitis by cisapride

Article Abstract:

Reflux esophagitis is an inflammatory condition affecting the esophagus, and is thought to be caused by excessive exposure of the esophageal mucosa (lining) to highly acidic gastric contents. In some cases, it may result from defective retention of the stomach's contents by the lower esophageal sphincter. Treatment takes the form of drugs that either suppress gastric acid secretion or enhance contractility of gastrointestinal smooth muscle (prokinetic drugs). Although acid-suppressing drugs are quite effective in producing short-term remission of reflux esophagitis, relapse occurs in between 40 and 80 percent of patients receiving long-term treatment to reduce acid secretion. To evaluate the short- and long-term effectiveness of a widely used prokinetic drug (cisapride) in preventing reflux esophagitis, a two-part study was carried out involving 138 patients between the ages of 16 and 75 years. All the patients were suffering from esophagitis of varying severity. In the first part of the study, patients were given cisapride for periods of time varying between 8 and 16 weeks; healing was obtained in 94 (69 percent) of the patients. Eighty of the healed patients continued into the second phase of the study, in which they were randomly assigned to receive either maintenance therapy with cisapride or an inactive placebo for an additional six months. At the end of the six-month period, significantly lower relapse rates were seen in the drug-treated patients (20 percent) than in the placebo-treated patients (39 percent). Cisapride is unlike drugs that only suppress gastric acid secretion and some other prokinetic drugs that cause short-term symptom remission but do not prevent relapse. The beneficial effects of cisapride include remission of symptoms and prevention of relapse. The incidence of adverse side effects was no greater in the drug-treated patients than in those receiving placebo. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Cisapride

---

Abnormal gastric adaptive relaxation in patients with gastrooesophageal reflux

Article Abstract:

During ordinary swallowing, a muscular wave of sequential relaxation and contraction (peristalsis) propels food and liquid to the junction of the esophagus and stomach (gastroesophageal junction), where a transient relaxation of the gastroesophageal sphincter muscle permits the ingested material to enter the stomach, which relaxes to accommodate the increased volume. Closure of the sphincter prevents reflux of the highly acidic gastric contents into the esophagus, where it would cause inflammation. In patients with gastroesophageal reflux, poorly understood disordered motility (movement) allows the acidic contents of the stomach to return to the esophagus. A variety of abnormalities of esophageal and gastric motility have been reported; however, little is known about the response of the stomach to the increased pressure resulting from ingestion. To investigate this, gastric pressure was measured during non-nutritive distention of the stomach in 15 healthy volunteers and 12 patients with symptomatic gastroesophageal reflux (with inflammation and pain). Endoscopy (evaluating the interior of the esophagus with a fiber-optic viewing device) revealed that five of the patients had no esophageal abnormalities, three had esophagitis (inflammation), and four had esophagitis with hiatal hernia (protrusion of the stomach up through the diaphragm). Subjects were intubated with a distensible bag containing a pressure monitor; the bag was inflated with a given volume (460 milliliters) of air over a 30-second period, and pressure was recorded. Contrary to what might have been expected, patients with gastroesophageal reflux had significantly reduced levels of intragastric pressure compared with controls. There was no correlation between intragastric pressure and sex, age, or body weight. (Consumer Summary produced by Reliance Medical Information, Inc.)

Gastrointestinal system, Gastrointestinal motility, Peristalsis

---

Similar abstracts:

• Abstracts: Influenza vaccination in the prevention of acute otitis media in children. The causes of hospital-treated acute lower respiratory tract infection in children
• Abstracts: Oestrogens, joint disease, and cartilage. Effects of cyclical etidronate combined with calcitriol versus cyclical etidronate alone on spine and femoral neck bone mineral density in postmenopausal osteoporotic women

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.