Strictures are a frequent complication of eosinophilic esophagitis. The efficacy and safety of topical corticosteroids and of dilation of eosinophilic esophagitis-associated strictures have not yet been thoroughly clarified. We present a retrospective analysis of 10 adult patients with eosinophilic esophagitis who had symptomatic esophageal stenosis that was unresponsive to topical corticosteroids, and who were treated using bougienage. Eight patients had one single stricture, one patient had two, and another had three strictures; mean stricture length was 2.1 cm (range 1 - 6 cm). Bougienage led to prompt symptom relief. Apart from transient postprocedural odynophagia, no severe complications occurred. During the follow-up (mean 6 months; range 2 - 11 months), all patients enjoyed sustained treatment response.

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The effect of ranitidine and cisapride on acid reflux and oesophageal motility was investigated in 18 patients with endoscopically verified erosive reflux oesophagitis. Each patient was treated with placebo, ranitidine (150 mg twice daily), and ranitidine (150 mg twice daily) plus cisapride (20 mg twice daily) in a double blind, double dummy, within subject, three way cross over design. Oesophageal acidity and motility were monitored under ambulatory conditions for 24 hours on the fourth day oftreatment, after a wash out period of 10 days during which patients received only antacids for relief of symptoms. Acid reflux was monitored by a pH electrode located 5 cm above the lower oesophageal sphincter. Intraoesophageal pressure was simultaneously recorded from four transducers placed 20, 15, 10, and 5 cm above the lower oesophageal sphincter. Upright reflux was three times higher than supine reflux (median (range) 13-3 (3 7-35 0)% v 3-7 (0-37-6)% of the time with pH<4*0, p<001, n=18). Compared with placebo, ranitidine decreased total reflux (from 10*0 (3.2-32.6)% to 6-4 (1.2-22-9)%, p<001), upright reflux (p<005), supine reflux (p<0001), and postprandial reflux (p<0-01), but did not affect oesophageal motility. The combination of ranitidine with cisapride further diminished the acid reflux found with ranitidine -that is, cisapride led to an additional reduction of total reflux (from 6*4 (1-2-22.9)% to 3-7 (1.0-12.7)%, p<001), supine reflux (p<0.05), and postprandial reflux (p

INTRODUCTION5-Hydroxytryptamine-3 (5-HT 3 ) receptor antagonists have been found to be potent anti-emetic drugs for chemotherapy-or radiation-induced nausea and vomiting.1±4 So far, four selective 5-HT 3 receptor antagonists (ondansetron, formerly GR 38032F; tropisetron, formerly ICS 205-930; granisetron, formerly BRL 43694; and dolasetron, formerly MDL 73147EF), with comparable clinical ef®cacy, are commercially available for these indications. The mechanism of the anti-emetic effect is not fully understood. 4 It is ascribed in part to central effects on the 5-HT 3 receptors in the area postrema, where the chemoreceptor trigger zone is located, with neural connections to the vomiting centre, but also in part to the peripheral action on 5-HT 3 receptors of afferent vagal ®bres in the stomach and small bowel.4±8 It has been suggested that the anti-emetic effect of 5-HT 3 may not only be due to suppression of nausea and the vomiting re¯ex, but also to direct or indirect effects on gastric motility. Although evidence for this latter assumption has been found in several animal SUMMARY Background: In previous studies, tropisetron has been shown to accelerate gastric emptying of a solid meal. However, it is uncertain whether other speci®c 5-hydroxytryptamine-3 receptor antagonists, such as ondansetron, also have a gastroprokinetic effect in humans. Aim: To evaluate the effect of ondansetron on gastric half-emptying time (T 1/2 ) of a solid meal, gastric myoelectrical activity and hormone levels in 14 healthy volunteers. Methods: In a placebo-controlled, randomized, crossover study, we investigated the effects of ondansetron (8 mg intravenously) on the gastric emptying of solids (by scintigraphy), gastric myoelectrical activity (by