Abstract
Thirteen infants (age range 1-24 mo; x-6.8 mo) with GER were studied with esophageal manometry (8) and 24 hr pH probe monitoring (13) to determine what effect metaclopramide has on LESP and reflux. Esophageal manometry was performed before and after intravenous metoclopramide (0.1 mg/kg). Twenty-four hr pH monitoring was divided into 2, 12 hr periods: A, no drug, and B, drug, metoclopramide 0.1 mg/kg/dose orally, given 30 min before every other 3 hr feeding. Mean LESP before metoclopramide, 17.9 mmHg; after, 26.3 mmHg (p<0.01). Statistical significance between A and B was achieved for the x̄ number of episodes of reflux (39.0 ±23.0 vs 22.2 ± 11.6) (p<0.025) and the x̄ duration of reflux (134.9 ±73.5 min vs 74.9 ± 42.1 min) (p<0.01), but not for the x̄ duration of each reflux episode (3.46 min vs 3.37 min) (p>0.5). Mean differences in the number of episodes of reflux and the duration without and with drug 1, 2, and 3 hrs postprandially were: 10.9 ± 8.58 vs 3.62 ± 5.53 (p<0.01) and 26.8 ± 22.3 min vs 7.69 ± 11.4 min (p<0.01); 12.8 ± 11.0 vs 3.31 ± 3.68 (p<0.005) and 48.5 ± 42.7 vs 15.9 ± 11.2 min (p<0.01); 9.31 ± 6.65 vs 5.00 ± 3.70 (p<0.05) and 36.8 ± 24.8 min vs 18.6 ± 16.0 min (p<0.025). We conclude that in infants with GER metoclopramide: 1) increases LESP, 2) decreases the total number of episodes of reflux, and 3) reduces the total time esophageal pH is <4.0. These later effects occur primarily during the first and second postprandial hours.
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Byrne, W., Marino, L. METOCLOPRAMIDE INCREASES LOWER ESOPHAGEAL SPHINCTER PRESSURE (LESP) AND REDUCES THE NUMBER OF EPISODES AND DURATION OF REFLUX IN INFANTS WITH GASTROESOPHAGEAL REFLUX (GER). Pediatr Res 18 (Suppl 4), 191 (1984). https://doi.org/10.1203/00006450-198404001-00591
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DOI: https://doi.org/10.1203/00006450-198404001-00591