The effect of oral and intravenous metoclopramide on human lower esophageal sphincter pressure.

Lower esophageal sphincter (LES) pressure was evaluated in response to oral or intravenous metoclopramide in normal subjects and in patients with symptomatic gastroesophageal reflux. Both the oral and intravenous administration of metoclopramide gave a dose-related increase in LES pressure. Complete dose-response curves to the oral compound showed greater absolute responsiveness in normals as compared to patients with LES incompetence. The generally accepted oral dose of 10.0 mg of metoclopramide gave a slight increase in LES pressure which was not consistent in all symptomatic patients. These studies suggest that higher doses of metoclopramide may be required for treating symptomatic gastroesophageal reflux secondary to LES incompetence.