The effect of domperidone on oesophageal emptying in diabetic autonomic neuropathy.

Abstract

1 Oesophageal emptying of solids was studied with a scintigraphic technique in 12 patients with insulin dependent diabetes complicated by autonomic neuropathy and in 22 control subjects. 2 In the diabetics the acute and chronic effects of oral domperidone on oesophageal emptying and symptoms of heartburn and dysphagia were assessed. 3 The number of swallows required to clear the oesophagus in the diabetics (median 9.5, range 2-30) was significantly greater (P < 0.001) than in normal controls (median 2, range 1-14). 4 Domperidone did not increase solid oesophageal emptying in diabetic patients either after acute or after chronic administration.

Domperidone: A Peripherally Acting Dopamine2-Receptor Antagonist

“…The acute and chronic oral administration of domperidone had no significant effect on esophageal emptying rates measured with scintigraphic technique in patients with diabetic gastroparesis. 38 The acute intramuscular administration of domperidone to infants with symptoms of GERD improved the percentage of peristaltic contractions in the body of the esophagus but did not significantly alter lower esophageal sphincter pressure or peristaltic amplitude. 39 Domperidone does not appear to affect colonic motility.…”

Weak and absent peristalsis

“…No effect of 20 mg domperidone on esophageal emptying was found on scintigraphy in 12 patients with diabetic autonomic neuropathy and esophageal dysfunction. 45 In contrast, a significant improvement in clearance was reported after administration of 10 mg intravenous metoclopramide in 14 patients with systemic sclerosis. 46 Motilin agonists Erythromycin and other macrolide antibiotics have pronounced prokinetic side-effects that are utilized by physicians treating patients with severe gastrointestinal dysmotility such as gastroparesis and pseudo-obstruction.…”

“…Effects on esophageal peristalsis and clearance are less well established. No effect of 20 mg domperidone on esophageal emptying was found on scintigraphy in 12 patients with diabetic autonomic neuropathy and esophageal dysfunction 45 . In contrast, a significant improvement in clearance was reported after administration of 10 mg intravenous metoclopramide in 14 patients with systemic sclerosis 46…”