Topical bethanechol for the improvement of esophageal dysmotility

A pilot study

Ashli O'Rourke, Paul Weinberger, Michele Morrison, Jeffrey Conklin, Gregory N Postma

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)481-486
Number of pages6
JournalAnnals of Otology, Rhinology and Laryngology
Volume122
Issue number8
DOIs
StatePublished - Jan 1 2013

Fingerprint

Esophageal Motility Disorders
Bethanechol
Swallows
Manometry
Sample Size

Keywords

  • Bethanechol
  • Dysphagia
  • Esophageal dysmotility
  • Esophageal hypoperistalsis
  • High resolution manometry
  • Ineffective esophageal motility

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Topical bethanechol for the improvement of esophageal dysmotility : A pilot study. / O'Rourke, Ashli; Weinberger, Paul; Morrison, Michele; Conklin, Jeffrey; Postma, Gregory N.

In: Annals of Otology, Rhinology and Laryngology, Vol. 122, No. 8, 01.01.2013, p. 481-486.

Research output: Contribution to journalArticle

O'Rourke, Ashli ; Weinberger, Paul ; Morrison, Michele ; Conklin, Jeffrey ; Postma, Gregory N. / Topical bethanechol for the improvement of esophageal dysmotility : A pilot study. In: Annals of Otology, Rhinology and Laryngology. 2013 ; Vol. 122, No. 8. pp. 481-486.
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abstract = "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.",
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