Domperidone: a Drug with Powerful Action on the Lower Esophageal Sphincter Pressure

Bron, B; Massih, Labib

doi:10.1159/000198476

Cited by 27 publications

(13 citation statements)

References 5 publications

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“…lower oesophageal sphincter maintains a normal pressure and reacts normally to physiologic and pharmacologic stimuli in cirrhotic patients (3,4,13). This was reconfirmed in the preliminary part of this study: as is the case in normals (7,14), domperidone at a 10-mg dose caused a dramatic increase in sphincter pressure. Therefore, although lower oesophageal sphincter pressure was not measured in the study group of patients, there seems little doubt that this dose of domperidone increased lower oesophageal sphincter pressure in all these patients.…”

Section: Resultssupporting

confidence: 76%

“…The latter effect, however, should be helpful in the management of variceal bleeding and prevention of recurrent gastrointestinal bleeding in patients with portal hypertension. Moreover, portography has recently shown a decrease in the estimated superior portosystemic circulation after domperidone (5) or metoclopramide (6)-two substances known to increase the lower oesophageal sphincter pressure (7). This study was designed to test this hypothesis, in patients with portal hypertension due to cirrhosis, using domperidone and observing whether this affected azygos blood flow-a better-validated reflection of superior portosystemic circulation (8)(9)(10).…”

Section: Lebrec M D Inserm U 24 Hbpital Beaujon 92118 Clichmentioning

confidence: 99%

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Domperidone-Induced Increase in Lower Oesophageal Sphincter Pressure Does Not Affect Azygos Blood Flow in Patients with Cirrhosis

Braillon

Capron-Chivrac

Valla

et al. 1986

Scandinavian Journal of Gastroenterology

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An increase in lower oesophageal sphincter pressure induced by domperidone has previously been reported to decrease superior portosystemic collateral flow in patients with portal hypertension owing to cirrhosis. Although a 10-mg intravenous dose of domperidone was effective in increasing lower oesophageal sphincter tone in a group of six patients with cirrhosis, the same dose failed to affect azygos blood flow in a matched group of six patients. The results do not support the hypothesis that an increase in lower oesophageal sphincter tone can decrease flow through oesophageal varices in patients with cirrhosis.

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Section: Resultssupporting

confidence: 76%

Section: Lebrec M D Inserm U 24 Hbpital Beaujon 92118 Clichmentioning

confidence: 99%

Domperidone-Induced Increase in Lower Oesophageal Sphincter Pressure Does Not Affect Azygos Blood Flow in Patients with Cirrhosis

Braillon

Capron-Chivrac

Valla

et al. 1986

Scandinavian Journal of Gastroenterology

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“…Domperidone, a selective dopamine receptor antagonist, is another therapeutic option to promote gastric motility that has also been shown to increase lower esophageal sphincter pressure. 12 …”

Section: Introductionmentioning

confidence: 99%

A review of medical therapy for proton pump inhibitor nonresponsive gastroesophageal reflux disease

Hillman

Yadlapati

Thuluvath

et al. 2017

Diseases of the Esophagus

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Introduction Up to 40% of patients report persistent gastroesophageal reflux disease (GERD) symptoms despite proton pump inhibitor (PPI) therapy. This review outlines the evidence for medical therapy for PPI non-responsive GERD. Materials and Methods A literature search for GERD therapies from 2005–2015 in PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews identified unique 2928 citations. Of those, 40 unique articles specific to the impact of PPI metabolizer genotype on PPI response and the use adjunctive medical therapies were identified. Results Thirteen articles reported impacts on CYP genotypes on PPI metabolism demonstrating lower endoscopic healing rates in extensive metabolizers; however, outcomes across genotypes were more uniform with more CYP independent PPIs rabeprazole and esomeprazole. Twenty-seven publications on 11 adjunctive medications showed mixed results for adjunctive therapies including nocturnal histamine-2 receptor antagonists, promotility agents, transient lower esophageal sphincter relaxation inhibitors, and mucosal protective agents. Discussion Utilizing PPI metabolizer genotype or switching to a CYP2C19 independent PPI is a simple and conservative measure that may be useful in the setting of incomplete acid suppression. The use of adjunctive medications can be considered particularly when the physiologic mechanism for PPI non-response is suspected. Future studies using adjunctive medications with improved study design and patient enrollment are needed to better delineate medical management options before proceeding to anti-reflux interventions.

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“…In order to characterize further the effects of drugs that increase LESP on the esophageal circulation in portal hypertension, the effects of metoclopramide and domperidone (11,12) on the azygos venous blood flow were investigated in a series of patients with cirrhosis and esophageal varices.…”

mentioning

confidence: 99%

Effects of metoclopramide and domperidone on azygos venous blood flow in patients with cirrhosis and portal hypertension

et al. 1986

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The effects of pharmacological manipulation of the lower esophageal sphincter pressure on the esophageal circulation in patients with cirrhosis and portal hypertension were investigated in 33 patients by measuring the azygos venous blood flow, which is an index of blood flow through esophageal varices and periesophageal collaterals draining into the azygos venous system. Measurements were performed in baseline conditions and after the blind administration of metoclopramide (20 mg i.v.) (12 patients), domperidone (10 mg i.v.) (12 patients) and placebo (9 patients). Both metoclopramide and domperidone caused a significant reduction of azygos blood flow, that decreased by 11.5% (p less than 0.01) and 15.6% (p less than 0.02) respectively, while no change was observed in patients receiving placebo (+1.4%, not statistically significant). Reduction of azygos blood flow represents a selective effect of metoclopramide and domperidone on the esophageal circulation, since portal pressure, hepatic blood flow, cardiac output, heart rate and arterial blood pressure were unchanged by the administration of metoclopramide, domperidone or placebo. These results indicate that the administration of drugs that increase the lower esophageal sphincter pressure may reduce the inflow of blood into the esophageal varices in cirrhotic patients with portal hypertension.

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Domperidone: a Drug with Powerful Action on the Lower Esophageal Sphincter Pressure

Cited by 27 publications

References 5 publications

Domperidone-Induced Increase in Lower Oesophageal Sphincter Pressure Does Not Affect Azygos Blood Flow in Patients with Cirrhosis

Domperidone-Induced Increase in Lower Oesophageal Sphincter Pressure Does Not Affect Azygos Blood Flow in Patients with Cirrhosis

A review of medical therapy for proton pump inhibitor nonresponsive gastroesophageal reflux disease

Effects of metoclopramide and domperidone on azygos venous blood flow in patients with cirrhosis and portal hypertension

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