ACUTE EFFECT OF METOCLOPRAMIDE ON ESOPHAG EAL MOTILITY IN DIABETICS

The acute effect of metoclopramide on oesophageal motility was investi gated prospectively in 33 consecutive patients (20 men and 13 women; m ean age 60.5 +/- 12.6 years) with type I (n = 8) or type II (n = 25) d iabetes. 15 patients had a peripheral sensory-motor polyneuropathy onl y and three just an autonomic cardial neuropathy. Both lesions were pr esent in ten, none in five. No patient had oesophagogastroduodenal les ions. Sphincter pressure, relaxation time, contraction amplitude and p ropulsion velocity of bolus-induced oesophageal peristalsis were measu red manometrically after intravenous administration of 10 mg metoclopr amide. Resting pressure in the lower oesophageal sphincter rose signif icantly by 26.7% contraction amplitude in the tubular portion of the o esophagus by more than 30%, and propulsion velocity by more than 20% ( P for each < 0.05). At the same time the amount of segmental and aperi staltic oesophageal contractions regressed significantly. The effect o f metoclopramide was demonstrated regardless of the type of diabetes, duration of diabetes and any manifestation of autonomic cardial or per ipheral sensory-motor neuropathy.