From the Research
Glucagon does not relax the esophagus, and its use is not recommended for conditions where esophageal relaxation is desired. The most recent and highest quality study, 1, which is a multicenter study published in 2016, found that glucagon had a low success rate in relieving esophageal foreign body impaction and was associated with adverse effects. This study suggests that glucagon does not offer advantages for treatment of esophageal conditions where relaxation is desired.
Key Findings
- The study 1 found that glucagon-related resolution of esophageal foreign body impaction occurred in only 14.2% of patients.
- Another study, 2, published in 1999, found that glucagon significantly reduced mean lower esophageal sphincter (LES) resting pressure, but this effect did not translate to a significant reduction in esophageal motility.
- An older study, 3, published in 1975, found that glucagon caused a transient significant decrease of LES pressure only at high doses, which caused nonphysiological elevation of plasma glucagon levels.
Mechanism of Action
Glucagon's effect on esophageal tone involves its interaction with specific receptors on smooth muscle cells, leading to changes in intracellular signaling that promote contraction rather than relaxation. This property makes glucagon unsuitable for medical conditions where esophageal relaxation is desired, such as achalasia or esophageal spasm.
Clinical Implications
Based on the available evidence, glucagon should not be used as a primary treatment for conditions where esophageal relaxation is desired. Instead, other medications like nitroglycerin, calcium channel blockers, or glucagon-like peptide-1 (GLP-1) analogs, which can relax the esophageal sphincter, should be considered.