Effect of doses of glucagon used to treat food impaction on esophageal motor function of normal subjects

We studied 10 normal subjects to determine the effect of doses of intraveno us glucagon used to treat food impaction on esophageal motor function. With a multilumen assembly perfused by a low compliance pneumohydraulic infusio n pump, esophageal manometry was performed during baseline and after random ized administration of 0.25, 0.5, and 1 mg intravenous glucagon. Mean proxi mal and distal amplitudes of contraction, proximal and distal amplitude of contraction duration, lower esophageal sphincter (LES) resting pressure, pe rcentage of LES relaxation, and glucagon-related side effects were evaluate d. No effect on proximal amplitude of contraction and proximal or distal es ophageal contraction duration was noted. Mean amplitude of contraction in t he distal esophagus was further reduced with increased dosage of glucagon b ut did not achieve statistical significance. Mean LES resting pressure was significantly reduced after 0.25 mg (18.7 +/- 1.8 vs. 10.2 +/- 1.5 mmHg, p = 0.0001) and further reduced after 0.5 mg (5.9 +/- 1.2 mmHg, p = 0.0009). Mean LES relaxation was significantly reduced after 0.25 mg (93.1 +/- 2.4% vs. 63.6 +/- 8.8%, p = 0.0031). The l-mg dose versus the 0.5-mg did not pro vide further reduction in any LES function parameters. One subject experien ced transient nausea after 0.5 mg, and 4 subjects experienced nausea after 1 mg glucagon. In conclusion, increased doses of glucagon further reduce me an distal esophageal amplitude of contraction. Although maximum reduction i n mean LES resting pressure was achieved with 0.5 mg, it did not provide an y potential therapeutic advantage over 0.25 mg glucagon. Nausea is a common , transient side effect predominantly affecting subjects treated with the 1 -mg dose.