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Salivary Function in Patients with Reflux Esophagitis: Effect of Cisapride

Department of Internal Medicine, Provincial Fong Yuan Hospital, Taichung; Departments of Nuclear Medicine and Internal Medicine, Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China

Correspondence: For correspondence or reprints contact: Chi-Sen Chang, MD, Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, 160, Sec. 3, Chung-Kang Rd., Taichung, Taiwan 407, Republic of China.

ABSTRACT

Saliva plays an important role in esophageal acid clearance. Reduction in salivary function has been considered in the pathogenesis of reflux esophagitis. Cisapride, a prokinetic agent, has been reported effective for treating mild-to-moderate grade gastroesophageal reflux disease. Some studies have shown that cisapride increases saliva volume and acid-buffering capacity. The aim of this study was to evaluate the effect of cisapride on salivary gland function by means of dynamic salivary scintigraphy. Methods: Fifty-five patients with endoscopie reflux esophagitis (Savary-Miller Grades I-II) were enrolled in this study. In Group 1 (n = 29), patients were evaluated during the fasting state, both before and after cisapride treatment (5 mg, 3 times/day, before meals, for 2 wk). In Group 2 (n = 26), patients were evaluated during the postprandial state, both before and after cisapride treatment. Uptake ratio (UR) and excretion ratio (ER) of the salivary gland in each group were compared using the paired Student's t-test. Results: In Group 1, no significant differences were found in UR or ER after cisapride treatment. However, in Group 2, ER increased significantly after treatment (p < 0.01), but UR did not show any significant change. Conclusion: Cisapride can increase the secretion function of salivary glands during the postprandial phase but not the fasting phase.

Key Words: cisapride • reflux esophagitis • salivary function • scintigraphy