EFFECTS OF CISAPRIDE ON LOWER ESOPHAGEAL SPHINCTER PRESSURE AND GASTRODUODENAL MOTOR ACTIVITY IN MAN

Manometric study was performed to investigate the effects of cisapride, a new nonantidopaminergic gastrointestinal prokinetic compound, on interdigestive lower esophageal sphincter pressure (LESP) and gastroduodenal motility using infused catheter technique. The subjects consisted of 9 healthy volunteers and 29 patients with progressive systemic sclerosis (19), reflux esophagitis (8) and others (2). 4 mg of cisapride was given by bolus injection, continuous infusion or oral administration. The following results were obtained: 1) Intravenous and oral cisapride increased LESP compared with basal pressure. Especially, bolus injection of cisapride caused a significant elevation of LESP during 30 minutes after administration. 2) After administration of cisapride, gastroduodenal motility was accelerated gradually, then inducing IMC-like contractions. By bolus injection, IMC-like contractions were induced in healthy subjects more frequently than in patients group.On the other hand, motility index of stomach and duodenum showed persistent increase in patients group compared with healthy subjects. 3) Cisapride-induced IMC-like contractions initiated from LES and upper part of stomach and mediated to duodenum, though aborad migration was not confirmed in the present study.