The effect of mosapride on esophageal motility and bolus transit in asymptomatic volunteers

Goals: To evaluate the effect of mosapride, a selective 5-hydroxytryptamine-4 agonist, on esophageal motility and bolus transit in asymptomatic volunteers. Study: Twenty healthy subjects participated in two experiments. 7 days apart, and we utilized a randomized, double-blind crossover design with 3-day pretreatments of placebo or mosapride. All subjects underwent combined intraluminal impedance manometry. Results: There was no difference in the amplitude, the duration, and the esophageal peristaltic patterns between the two pretreatments. The lower esophageal sphincter (LES) pressure and the number of transient LES relaxations did not change after mosapride vs. placebo. However, the rate of complete bolus transit in liquid swallows was higher with mosapride pretreatment (92.2%) than with placebo (84.6%; P < 0.01). The total bolus transit time in all liquid swallows showed a tendency to shorten after mosapride treatment (P = 0.06). The liquid bolus transit became faster after mosapride, especially in manometrically ineffective liquid swallows (P < 0.01). The total bolus transit time for manometrically normal viscous swallows decreased after pretreatment with mosapride (7.7 seconds: range, 6.8-9.2) in comparison with placebo (8.1 seconds; range. 7.1-11.1: P < 0.05). Conclusions: Mosapride increases the rate of complete bolus transit in the esophagus, and enhances esophageal bolus transit in asymptomatic volunteers.