Question:medium
A 40-year-old male patient presents with GERD. Which of the following drugs helps in contraction of the lower esophageal sphincter and increases gastric emptying?
A 40-year-old male patient presents with GERD. Which of the following drugs helps in contraction of the lower esophageal sphincter and increases gastric emptying?
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GERD with need for prokinetic action: metoclopramide increases LES tone and gastric emptying.
Updated On: May 14, 2026
- Metoclopramide
- Pantoprazole
- Vonoprazan
- Sodium alginate
Show Solution
The Correct Option is A
Solution and Explanation
Step 1: Understanding the Question:
The question seeks a drug that addresses the physiological "motility" issues in GERD—namely, a weak lower esophageal sphincter (LES) and slow stomach emptying.
Step 2: Detailed Explanation:
Mechanism of Metoclopramide: This drug is a prokinetic agent. It acts as a selective \(D_2\) receptor antagonist in the gastrointestinal tract. It also has \(5-HT_4\) receptor agonist properties.
Actions in GERD: Metoclopramide increases the resting tone of the Lower Esophageal Sphincter (preventing reflux) and enhances the motility of the upper GI tract, which speeds up gastric emptying.
Why others are incorrect: Pantoprazole (Option B) is a Proton Pump Inhibitor (PPI) and Vonoprazan (Option C) is a Potassium-competitive acid blocker (P-CAB). Both are highly effective at reducing acid production but do not directly influence GI motility or LES tone. Sodium alginate (Option D) forms a physical "raft" on top of stomach contents to block reflux but does not increase LES contraction.
Side Effects: Because Metoclopramide crosses the blood-brain barrier and blocks dopamine receptors in the CNS, it can cause extrapyramidal side effects (EPS), such as dystonia or tardive dyskinesia, which limits its long-term use.
Step 3: Final Answer:
Metoclopramide is the prokinetic agent that increases LES tone and accelerates gastric emptying in patients with GERD.
The question seeks a drug that addresses the physiological "motility" issues in GERD—namely, a weak lower esophageal sphincter (LES) and slow stomach emptying.
Step 2: Detailed Explanation:
Mechanism of Metoclopramide: This drug is a prokinetic agent. It acts as a selective \(D_2\) receptor antagonist in the gastrointestinal tract. It also has \(5-HT_4\) receptor agonist properties.
Actions in GERD: Metoclopramide increases the resting tone of the Lower Esophageal Sphincter (preventing reflux) and enhances the motility of the upper GI tract, which speeds up gastric emptying.
Why others are incorrect: Pantoprazole (Option B) is a Proton Pump Inhibitor (PPI) and Vonoprazan (Option C) is a Potassium-competitive acid blocker (P-CAB). Both are highly effective at reducing acid production but do not directly influence GI motility or LES tone. Sodium alginate (Option D) forms a physical "raft" on top of stomach contents to block reflux but does not increase LES contraction.
Side Effects: Because Metoclopramide crosses the blood-brain barrier and blocks dopamine receptors in the CNS, it can cause extrapyramidal side effects (EPS), such as dystonia or tardive dyskinesia, which limits its long-term use.
Step 3: Final Answer:
Metoclopramide is the prokinetic agent that increases LES tone and accelerates gastric emptying in patients with GERD.
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