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Effects of Codeine on Esophageal Peristalsis in Patients With Ineffective Esophageal Motility: Studies Using High-resolution Manometry

Wei-yi Lei ; Tso-tsai Liu ; Wei-chuan Chang ; Chih-hsun Yi ; Jui-sheng Hung ; Ming-wun Wong ; Shu-wei Liang ; Lin Lin ; Chien-lin Chen

Journal of neurogastroenterology and motility, 2024-01, Vol.30 (1), p.38 [Periódico revisado por pares]

대한소화기기능성질환·운동학회

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  • Título:
    Effects of Codeine on Esophageal Peristalsis in Patients With Ineffective Esophageal Motility: Studies Using High-resolution Manometry
  • Autor: Wei-yi Lei ; Tso-tsai Liu ; Wei-chuan Chang ; Chih-hsun Yi ; Jui-sheng Hung ; Ming-wun Wong ; Shu-wei Liang ; Lin Lin ; Chien-lin Chen
  • Assuntos: Humans ; Manometry ; Peristalsis
  • É parte de: Journal of neurogastroenterology and motility, 2024-01, Vol.30 (1), p.38
  • Notas: The Korean Society of Gastrointestinal Motility
  • Descrição: Background/Aims This study aims to evaluate the effects of acute codeine administration on primary and secondary esophageal peristalsis in patients with ineffective esophageal motility (IEM). Methods Eighteen IEM patients (8 women; mean age 37.8 years, range 23-64 years) were enrolled in the study. The patients underwent high-resolution manometry exams, consisting of 10 single wet swallows, multiple rapid swallows, and ten 20 mL rapid air injections to trigger secondary peristalsis. All participants completed 2 separate sessions, including acute administration of codeine (60 mg) and placebo, in a randomized order. Results Codeine significantly increased the distal contractile integral (566 ± 81 mmHg·s·cm vs 247 ± 36 mmHg·s·cm, P = 0.001) and shortened distal latency (5.7 ± 0.2 seconds vs 6.5 ± 0.1 seconds, P < 0.001) for primary peristalsis compared with these parameters after placebo treatment. The mean total break length decreased significantly after codeine treatment compared with the length after placebo (P = 0.003). Codeine significantly increased esophagogastric junction-contractile integral (P = 0.028) but did not change the 4-second integrated relaxation pressure (P = 0.794). Codeine significantly decreased the frequency of weak (P = 0.039) and failed contractions (P = 0.009), resulting in increased frequency of normal primary peristalsis (P < 0.136). No significant differences in the ratio of impaired multiple rapid swallows inhibition and parameters of secondary peristalsis were detected. Conclusions In IEM patients, acute administration of codeine increases contraction vigor and reduces distal latency of primary esophageal peristalsis, but has no effect on secondary peristalsis. Future studies are required to further elucidate clinical relevance of these findings, especially in the setting of gastroesophageal reflux disease with IEM. (J Neurogastroenterol Motil 2024;30:38-45)
  • Editor: 대한소화기기능성질환·운동학회
  • Idioma: Coreano
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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