Prevention of meal-induced heartburn and regurgitation with metoclopramide in patients with gastroesophageal reflux.

Ten patients with gastroesophageal reflux disease participated in a randomized, double-blind, crossover study in which they received a single 20-mg oral dose of metoclopramide or a placebo 15 minutes before a provocative test meal. All patients had previously been challenged with the test meal and had exhibited symptoms of heartburn and regurgitation. Metoclopramide reduced the severity of heartburn from the onset, its effect reaching statistical significance within two hours and persisting for at least five hours. Eighty percent of the patients who received metoclopramide, compared with only 30% of placebo-treated patients, were completely free of heartburn at the end of the trial. A significant reduction in regurgitation during the 1 1/2 to four hours after the test meal was also noted with metoclopramide. No adverse effects occurred. The ability of metoclopramide to prevent the symptoms of heartburn and regurgitation induced by a provocative meal in patients with gastroesophageal reflux was clearly demonstrated.