الفهرس 
Lower esophageal sphincterOnly 14 pages are availabe for public view
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Abstract
Twenty five patients were diagnosed to have irritable
bowel syndrome after clinical examination •
haematological investigations, sigmoidoscopy with
rectal biopsy. They were classified into 2 groups
group I who complained of symptoms suggestive of gastroesophageal
reflux and group II who did not complain
of symptoms suggestive of gastro~esophagea1 reflux.
Group I patients were aasessed clinically and by
upper gastro-intestina1 endoscopy, biopsy was taken
from the distal esophageal mucosa and the pH of the
esophageal ref1uxate was meas~red. All of these investigations
showed evidence of gastro-esophagea1 reflux
which could be demonstrated in 15 patients of irritable
bowel syndrome.
Therefore we conclude that ~astro-esophagea1 reflux
is significantly prevalent in the irritable bowel
syndrome and is frequently associated with esophagitis,
and it explains the presence of upper GI manifestation
in IBS.
Domperidone (Moti1ium) which is 8 dopamine antagonist
that acts only on the peripheral dopamine receptors
was given to all the patients in a dosage of 1 tablet
(= 10 mg) before meals t.d.s. orally for one month
with certain dietary measures as lines of treatment
of gastroesophageal reflux in group I patients and
group II patients were considered as control cases.
During treatment there was marked improvement
of symptoms as 80% of cases previously complained of
heart burn improved, 75% of cases previously complained
of epigastric pain improved and 80% of cases previously
complained of regurgitation of bitter fluid improved.
After stoppage of treatment 20% of cases recomplained
of recurrence of the previous complaints before
treatment, this is most probably due to persistence
of the irritable bowel dysfunction.
Domperidone has no effect on lower gastro-intestinal
symptoms as mentioned by both groups patients.Endoscopical
examination of patients after treatment showed
no macroscopic evidence of gastro-esophageal reflux in
66.7% of cases. Histological examination of biopsies
showed evidence of esophagitis in 60% of group I patients
before treatment and in 33.4 % of them after treatment.
Recording of pH of the esophageal refluxate showed
p < 0.001 in group I cases which is highly significant
and P > 0.05 in group II cases which is insignificant.
There were no observed side effects during treatment.
So, we conclude that domperidone (Motilium) can
be successfully used for control of symptoms of gastroesophageal
reflux and without production of significant
side effects.