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Background  Gastroesophageal reflux disease (GERD) is associated with lower esophageal sphincter (LES) incompetence. In some patients, GERD is refractory to acid reduction therapy which is the main treatment for GERD. So far, medications that can increase LES tone are few.  Arecae pericarpium (A. pericarpium)  is a medication in Traditional Chinese Medicine known to promote intestinal motility.    Methods  We investigated the effect of  A. pericarpium  extracts on porcine LES motility. In addition, we used tetrodotoxin (TTX) and atropine to study the underlying mechanism of  A. pericarpium  extracts-induced contractions of LES.    Results  The results of this study showed that  A. pericarpium  extracts and their main active ingredient, arecoline, can induce the contractions of porcine LES sling and clasp muscles in a dose-response manner. TTX did not have an inhibitory effect on the contractions induced by  A. pericarpium  extracts and arecoline in LES. However, atropine significantly inhibited  A. pericarpium  extracts- and arecoline-induced contractions of LES.    Conclusion   A. pericarpium  extracts can induce the contractions of porcine LES in a dose dependent manner, possibly through muscarinic receptors, and hence, may be worth developing as an alternative therapy for GERD.

Arecae pericarpium extract induces porcine lower-esophageal-sphincter contraction via muscarinic receptors