Pharmacological constriction of the lower oesophageal sphincter: a simple method of arresting variceal haemorrhage.

Hosking, S. W.; Doss, Wahid; el-Zeiny, H; Robinson, P.; Barsoum, Mohsen Samy; Johnson, A. G.

doi:10.1136/gut.29.8.1098

Cited by 46 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In theory they could reduce the blood How through the varices. Metoclopramide reduces transmural esophageal variceal pressure but has no effect on portal haemodynamics [49], Although a small study by Hosking et al [50] suggested metoclopramide could reduce bleeding, this has not been confirmed in other studies. Feu ct al.…”

Section: Pharmacological Controlmentioning

confidence: 68%

Medical Management of Bleeding Esophageal Varices

Burroughs

1992

Dig Dis

View full text Add to dashboard Cite

Vasoactive drug therapy is the only therapy that can be administered immediately to patients with suspected variceal bleeding. The optimal agent is not yet available, but somatostatin or octreotide, glypressin and vasopressin and nitroglycerin are the best candidates. Somatostatin and octreotide have the best therapeutic index as they have very few side effects. They compare well to the other agents in comparative randomized trials. In addition to being used prior to sclerotherapy, vasoactive agents may show benefit when used in combination with endoscopic methods and in the immediate interval thereafter in order to prevent early re-bleeding. This remains to be tested in clinical trials.

show abstract

Section: Pharmacological Controlmentioning

confidence: 68%

Medical Management of Bleeding Esophageal Varices

Burroughs

1992

Dig Dis

View full text Add to dashboard Cite

show abstract

“…This is in agreement with a preliminary report by Kleber et al [11], who found a 16% decrease in IOVP 20 min after intravenous metoclo pramide. This suggests that the recently de scribed beneficial effect of metoclopramide on bleeding from oesophageal varices [6] might be due to the reduction in IOVP in duced by metoclopramide. However, a pre liminary report by Feu et al [12] indicates that metoclopramide is not effective in the prevention of oesophageal rebleeding.…”

Section: Discussionmentioning

confidence: 93%

“…This finding has not been confirmed by other investiga tors [10], The recent improvement of the technique for the determination of IOVP by Staritz et al [8] has provided a valuable tool to better understand the haemodynamics of oesophageal varices. Recently Hosking et al [6] found a marked IOVP drop after con stricting LOS by intravenous pentagastrin. In our study, metoclopramide, which in creases LOS pressure by acting on receptors other than those for pentagastrin, was also found to significantly decrease IOVP.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, domperidone and meto clopramide have been shown to reduce the azygous blood How [5], which is considered an index of blood flow through gastro-oesophageal collaterals in portal hypertension. Recently, Hosking et al [6] demonstrated that intravenous pentagastrin induced a sig nificant fall in transmural variceal pressure, and that metoclopramide was effective to arrest the variceal bleeding originating from the lowest 2 cm oesophagus.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Metoclopramide on Transmural Oesophageal Variceal Pressure and Portal Blood Flow in Cirrhotic Patients

Taranto¹,

Suozzo²,

Sio³

et al. 1990

Digestion

View full text Add to dashboard Cite

This study was undertaken to evaluate the effect of metoclopramide on transmural oesophageal variceal pressure and portal blood flow in cirrhotic patients. Sixteen cirrhotics were randomly assigned to metoclopramide (10 mg i.v.) or saline. Metoclopramide significantly decreased transmural variceal pressure (15.7% decrease, p < 0.05 vs. basal value). In order to evaluate if the metoclopramide-induced drop in transmural variceal pressure was due to an effect on portal haemodynamics, we also measured, by means of real time and pulsed Doppler ultrasonography, portal vein diameter, mean velocity of portal flow, and portal venous flow. No significant change was observed before and after metoclopramide. In conclusion, metoclopramide, which increases lower oesophageal sphincter pressure, significantly decreases transmural variceal pressure in cirrhotic patients. However, it does not have any effect on portal haemodynamics.

show abstract

“…Comparisons can only be made with drugs has been shown to reduce transmural oesophageal variceal pressure, but has no effect on portal haemodynamics in a selected group of patients who have the same severity of bleeding, and the available trials do not address this [78]. A single small study suggested that metaclopramide could reduce bleeding at the time of endoscopy [79], but question. Furthermore, it is difficult to justify such studies today.…”

Section: Metoclopramide and Domperidonementioning

confidence: 99%

Pharmacological Treatment of Acute Variceal Bleeding

Burroughs¹

1998

Digestion

View full text Add to dashboard Cite

A review of the progress in pharmacological treatment of portal hypertension is best considered in the clinical setting of the acute variceal bleeding episode, the primary prophylaxis of variceal bleeding, and prevention of rebleeding from varices and portal hypertensive gastropathy. The data from randomized trials has been evaluated using meta-analysis when possible, and a conclusion made regarding the optimal drug or other therapy in the particular clinical setting. A recent meta-analytic review has been published [1].

show abstract

Pharmacological constriction of the lower oesophageal sphincter: a simple method of arresting variceal haemorrhage.

Cited by 46 publications

References 14 publications

Medical Management of Bleeding Esophageal Varices

Medical Management of Bleeding Esophageal Varices

Effect of Metoclopramide on Transmural Oesophageal Variceal Pressure and Portal Blood Flow in Cirrhotic Patients

Pharmacological Treatment of Acute Variceal Bleeding

Contact Info

Product

Resources

About