Effects of morphine and naloxone on esophageal motility and gastric emptying in man

Abstract

We studied the effect of morphine and naloxone on lower esophageal sphincter pressure, esophageal contraction amplitude, and gastric emptying of solids and liquids in ten normal healthy subjects. Morphine sulfate in a dose of 8 mg intravenous bolus significantly decreased sphincter pressure with a maximum fall of 22.8% of the basal tone. Naloxone, 5 mg intravenous bolus, resulted in a 20% increase in the baseline pressure. There was no change in the esophageal contraction amplitude, duration, or frequency of peristalsis with either morphine or naloxone. Gastric emptying was measured using a dual-isotope technique to simultaneously asses the emptying rates of both solid and liquid meal components. Morphine, 8 mg intravenous bolus, led to a significant inhibition (P<0.05) of the gastric emptying of both solids (^99mTc sulfur colloid-labeled chicken liver) and liquids (¹¹¹In DTPA-labeled water). Naloxone, 5 mg intravenous bolus, accelerated the gastric emptying of both solid and liquid components, but this did not achieve statistical significance. These observations suggest that: (1) morphine's inhibitory effect on gastric emptying and lower esophageal sphincter pressure may contribute to its potent emetic properties; (2) the human lower esophageal sphincter and stomach may have opiate receptors and further investigations should be addressed to determining if endogenous opiates play a role in the modulation of sphincter pressure and gastric emptying in humans.