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Effect of metoclopramide on normal and delayed gastric emptying in gastroesophageal reflux patients

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Abstract

Gastric emptying has an important role in the pathophysiology of gastroesophageal reflux disease. We investigated the effect of metoclopramide, a gastric prokinetic agent, in gastroesophageal reflux patients with normal as well as delayed emptying. Twenty-six patients with subjective and objective evidence of gastroesophageal reflux ingested an egg salad sandwich meal labeled with99mtechnetium-DTPA for a baseline study, and then again on a separate day after receiving oral metoclopramide, 10 mg, 30 min prior to the test meal. The mean percent isotope remaining in the stomach after 90 min improved significantly (P<0.001) from 70.3±3.9% (sem) to 55.2±4.2% after metoclopramide. Fourteen (54%) had a basal emptying in the normal range of 34–69% retention of isotope at 90 min,\((\bar X \pm 2SD)\), while it was slow in 12 (46%). For those with delayed basal gastric emptying, the mean retention of 88.9±2.9% at 90 min was significantly (P<0.005) decreased by metoclopramide to 68.6±6.1%. In those patients with a normal basal gastric emptying and a mean retention of 54.4±2.3% at 90 min, there was also significant improvement (P<0.025) to 43.6±3.6% after metoclopramide. These data indicate that metoclopramide increased gastric emptying in gastroesophageal reflux patients with normal as well as delayed gastric emptying. Therefore on a patient management level a trial of metoclopramide is warranted in patients with gastroesophageal reflux disease and is not limited by the gastric emptying status of the patient.

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Authors and Affiliations

  1. Departments of Medicine and Nuclear Medicine, Yale University School of Medicine, New Haven, Connecticut

    Steven M. Fink MD, Robert C. Lange PhD &  Richard W. McCallum MD

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  1. Steven M. Fink MD
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  2. Robert C. Lange PhD
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  3. Richard W. McCallum MD
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Fink, S.M., Lange, R.C. & McCallum, R.W. Effect of metoclopramide on normal and delayed gastric emptying in gastroesophageal reflux patients. Digest Dis Sci 28, 1057–1061 (1983). https://doi.org/10.1007/BF01295802

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  • DOI: https://doi.org/10.1007/BF01295802

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