Official websites use. Share sensitive information only on official, secure websites. Correspondence to: Dr. AIM: Itopride is a newly developed prokinetic agent, which enhances gastric motility through both antidopaminergic and anti-acetylcholinesterasic actions.
The importance of esophageal motor dysfunction in the pathogenesis of gastro-esophageal reflux disease GERD makes it interesting to examine the effect of itopride on esophageal acid exposure. Ambulatory h pH-metry and symptom assessment were performed after treatments with or mg itopride thrice a day t. For evaluating the safety of itopride, blood biochemical laboratory test was performed and the serum prolactin level was also examined before and after treatment.
No serious adverse effects were observed with administration of itopride in both groups. Gastro-esophageal reflux disease GERD is characterized by the reflux of gastric content into esophagus with or without histological changes. Pathogenesis of GERD are lower esophageal sphincter LES dysfunction, abnormal clearing capacity of refluxed materials, delayed gastric emptying and abnormal resistance of esophageal mucosa to gastric acid, but the primary motor dysfunction is regarded as the most important factor in general[ 1 , 2 ].
Therefore, prokinetic agent that restores gastric motility with increasing of LES and esophageal motility has been developed and used frequently in the treatment of GERD[ 3 ]. There are several prokinetic agents such as bethanechol, metoclopramide, domperidone, and cisapride that potentiate acetylcholine effects on smooth muscle of gastrointestinal tract or antagonize the activity of dopamine. However, these prokinetic agents have some limitations for prescribing to GERD patients, because they show uncertain efficacies on GERD except for cisapride and have some problems in safety[ 4 , 5 ].
Especially, cisapride accelerates the esophageal acid clearance by an enhancement of esophageal propulsive motility, which strengthens LES and stimulates the gastric emptying. So it is regarded that cisapride has the same efficacy as an inhibitor of gastric acid secretion for GERD.
