TY - JOUR
T1 - Topical bethanechol for the improvement of esophageal dysmotility
T2 - A pilot study
AU - O'Rourke, Ashli
AU - Weinberger, Paul
AU - Morrison, Michele
AU - Conklin, Jeffrey
AU - Postma, Gregory
PY - 2013/8
Y1 - 2013/8
N2 - Objectives: We studied a case series to evaluate the effect of topical bethanechol chloride on esophageal function in individuals with ineffective esophageal motility. Methods: Five subjects with ineffective esophageal motility underwent high resolution esophageal manometry. Ten 5 mL liquid swallows were performed to establish a baseline. Five milligrams of topical bethanechol was then administered. After 10 minutes, the subjects completed 10 additional liquid swallows. This procedure was repeated with 10 mg of bethanechol in 4 subjects. Results: After administration of 5 mg of topical bethanechol, the mean (±SD) distal contractile integral, an index of esophageal contractility, increased from 178.3 ± 83.1 mm Hg•s•cm to 272.3 ± 216.9 mm Hg•s•cm (p = 0.69). The percentage of failed swallows decreased from 52.8% ± 33.2% to 29.4% ± 18.3% (p = 0.14). The percentage of peristaltic swallows increased from 28.0% ± 26.8% to 67.2% ± 15.3% (p = 0.04). The contractile front velocity was essentially unchanged. After administration of 10 mg of bethanechol, the distal contractile integral decreased from 349.3 ± 371.0 mm Hg•s•cm to 261.8 ± 293.5 mm Hg•s•cm (p = 0.72). The percentage of failed swallows increased from 57.5% ± 37.7% to 66.8% ± 24.9% (p = 0.46). The percentage of peristaltic swallows increased from 17.5% ± 23.6% to 28.3% ± 19.1% (p = 0.29). The contractile front velocity decreased from 11.6 ± 5.2 cm/s to 4.9 ± 3.0 cm/s (p = 0.32). No adverse side effects occurred. Conclusions: The results of this pilot study support the need for further investigation with larger sample sizes and dose escalation.
AB - Objectives: We studied a case series to evaluate the effect of topical bethanechol chloride on esophageal function in individuals with ineffective esophageal motility. Methods: Five subjects with ineffective esophageal motility underwent high resolution esophageal manometry. Ten 5 mL liquid swallows were performed to establish a baseline. Five milligrams of topical bethanechol was then administered. After 10 minutes, the subjects completed 10 additional liquid swallows. This procedure was repeated with 10 mg of bethanechol in 4 subjects. Results: After administration of 5 mg of topical bethanechol, the mean (±SD) distal contractile integral, an index of esophageal contractility, increased from 178.3 ± 83.1 mm Hg•s•cm to 272.3 ± 216.9 mm Hg•s•cm (p = 0.69). The percentage of failed swallows decreased from 52.8% ± 33.2% to 29.4% ± 18.3% (p = 0.14). The percentage of peristaltic swallows increased from 28.0% ± 26.8% to 67.2% ± 15.3% (p = 0.04). The contractile front velocity was essentially unchanged. After administration of 10 mg of bethanechol, the distal contractile integral decreased from 349.3 ± 371.0 mm Hg•s•cm to 261.8 ± 293.5 mm Hg•s•cm (p = 0.72). The percentage of failed swallows increased from 57.5% ± 37.7% to 66.8% ± 24.9% (p = 0.46). The percentage of peristaltic swallows increased from 17.5% ± 23.6% to 28.3% ± 19.1% (p = 0.29). The contractile front velocity decreased from 11.6 ± 5.2 cm/s to 4.9 ± 3.0 cm/s (p = 0.32). No adverse side effects occurred. Conclusions: The results of this pilot study support the need for further investigation with larger sample sizes and dose escalation.
KW - Bethanechol
KW - Dysphagia
KW - Esophageal dysmotility
KW - Esophageal hypoperistalsis
KW - High resolution manometry
KW - Ineffective esophageal motility
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U2 - 10.1177/000348941312200801
DO - 10.1177/000348941312200801
M3 - Article
C2 - 24027856
AN - SCOPUS:84883040348
SN - 0003-4894
VL - 122
SP - 481
EP - 486
JO - Annals of Otology, Rhinology and Laryngology
JF - Annals of Otology, Rhinology and Laryngology
IS - 8
ER -