Cimetidine and metoclopramide in oesophageal reflux disease

Abstract

Although cimetidine is effective in oesophageal reflux disease, it is not as consistently useful as in peptic ulceration. Metoclopramide increases lower oesophageal sphincter pressure in normal subjects and patients with reflux and speeds gastric emptying. These properties together with the acid lowering effect of cimetidine appeared to provide a sound rationale for combination therapy. Although the effect on symptoms was comparable, the combination of metoclopramide and cimetidine appeared less effective in this study in producing endoscopic improvement and healing than cimetidine alone, although this difference did not reach statistical significance. A possible explanation might be that metoclopramide reduced the bioavailability of cimetidine.