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Am J Physiol Gastrointest Liver Physiol 274: G984-G991, 1998;
0193-1857/98 $5.00
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Vol. 274, Issue 6, G984-G991, June 1998

Effects of long-term oral L-arginine on esophageal motility and gallbladder dynamics in healthy humans

Y. C. Luiking1, B. L. A. M. Weusten2, P. Portincasa2, R. Van Der Meer3, A. J. P. M. Smout2, and L. M. A. Akkermans1

Departments of 1 Surgery and 2 Gastroenterology, University Hospital Utrecht, 3584 CX Utrecht; and 3 Department of Nutrition, Netherlands Institute for Dairy Research, 6718 ZB Ede, The Netherlands

Inhibitory nitrergic neurons are known to play a role in the regulation of motility patterns of the distal esophagus, the lower esophageal sphincter (LES), and the gallbladder. Our study aim was to investigate the effects of "long-term" (i.e., prolonged) oral intake of L-arginine (L-Arg), the endogenous source for nitric oxide (NO) synthesis, on postprandial LES pressure (LESP), esophageal motility, gastroesophageal reflux, and gallbladder motility. L-Arg (30 g/day) or glycine (placebo; 13 g/day; isosmolar) was given orally to 10 healthy male volunteers for 8 days, according to a randomized, crossover design. Twenty-four-hour urinary nitrite/nitrate excretion was measured to indicate NO synthesis. Basal early postprandial LESP was lower after L-Arg ingestion (2.2 kPa) than after glycine ingestion (2.7 kPa) (P < 0.05). L-Arg abolished the physiological late postprandial rise in LESP. Transient LES relaxations were longer lasting after L-Arg ingestion (P < 0.02). Esophageal motility and reflux were not affected (not significant). Fasting and residual gallbladder volumes were greater after L-Arg ingestion (P < 0.05). Urinary nitrite/nitrate excretion was higher after L-Arg intake (P < 0.05). In conclusion, long-term oral L-Arg suppresses late postprandial LESP increase, prolongs transient LES relaxations, and increases fasting and residual gallbladder volumes. These effects may be mediated by increased NO synthesis.

nitric oxide; lower esophageal sphincter; nitrate


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