Effect of mosapride combined with esomeprazole improves esophageal peristaltic function in patients with gastroesophageal reflux disease: a study using high resolution manometry.

Abstract:

BACKGROUND:Whether addition of prokinetics to proton pump inhibitors improves esophageal peristalsis and symptoms in patients with gastroesophageal reflux disease (GERD) remains unknown. AIM:We evaluated the effect of mosapride, a 5-HT4 agonist, and PPI cotherapy in patients with GERD on esophageal motility using high-resolution manometry (HRM). METHOD:This study was designed as a double-blind, randomized, placebo-controlled trial. Patients with GERD were allocated to a group either taking 40 mg esomeprazole plus 30 mg mosapride or taking esomeprazole plus placebo. Symptom assessment and the HRM study were conducted before drug treatment and after 4 weeks. RESULTS:Of 50 patients enrolled, 24 in the mosapride group (49 years old, 15 males) and 19 in the placebo group (43 years old, nine males) completed the study. Approximately 79 % of the patients had normal peristaltic function. Treatment response was not different between the two groups (79 vs. 68 %). Mosapride cotherapy tended to yield better response in patients with dyspepsia than those without dyspepsia (92 vs. 67 %). Lower esophageal sphincter pressure didn't change in both groups. Intrabolus pressure decreased in the mosapride group (3.4 ± 3.5 mmHg to 1.4 ± 4.1 mmHg, P < 0.05). Distal esophageal amplitude increased in the mosapride group and not in the placebo group (81 ± 34 to 89 ± 29 mmHg vs. 82 ± 32 to 83 ± 31 mmHg). CONCLUSION:Adding mosapride on esomeprazole improved esophageal contractability and lowered intrabolus pressure in patients with GERD. Mosapride and esomeprazole cotherapy tended to yield better response in patients with concomitant dyspepsia.

journal_name

Dig Dis Sci

authors

Cho YK,Choi MG,Park EY,Lim CH,Kim JS,Park JM,Lee IS,Kim SW,Choi KY

doi

10.1007/s10620-012-2430-y

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

1035-41

issue

4

eissn

0163-2116

issn

1573-2568

journal_volume

58

pub_type

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