Cisapride in children with chronic intestinal pseudoobstruction. An acute, double-blind, crossover, placebo-controlled trial.

Abstract

To assess the effect of cisapride on gastrointestinal motility and gastric emptying in children with chronic intestinal pseudoobstruction, 20 children (mean age, 4.9 years; 14 female and 6 male) who required special means of alimentation or who had severe symptoms confirmed by diary during 2 weeks before the study were studied. A motility catheter with recording sites in the antrum and duodenum was placed on the first day of the study and remained in place until the end of the 5-day study. Cisapride (0.3 mg/kg PO t.i.d.) or placebo was given in double-blind randomized crossover fashion, with a 2-day "washout" interval. Antroduodenal motility was recorded on days 2 and 5. Recording consisted of 4 hours of fasting and 2 hours after a complex liquid meal labeled with 99mTc. Gastric emptying was assessed for 1 hour after the meal. Based on manometry, 16 patients had neuropathic and 4 patients had myopathic disorders. Cisapride had no effect on the discrete, qualitative abnormalities found in individual records. Cisapride increased the postprandial duodenal motility index from 1180 +/- 256 mm Hg/30 min after placebo to 2385 +/- 430 mm Hg/30 min (P less than 0.05) but had no significant effect on the antral motility index. Cisapride did not alter the profound delay in gastric emptying; time to reach 50% of initial activity (T1/2) was 105 +/- 20 vs. 93 +/- 19 minutes and percentage of retention after 60 minutes (R60) 56% +/- 4% vs. 58% +/- 4% in control vs. cisapride, respectively. In summary, in children with chronic intestinal pseudoobstruction, cisapride increased postprandial duodenal motility but did not improve gastric emptying.

• Authors: C Di Lorenzo, S N Reddy, J Villanueva-Meyer, I Mena, S Martin, P E Hyman
• Journal: Gastroenterology (Gastroenterology) Vol. 101 Issue 6 Pg. 1564-70 (Dec 1991) ISSN: 0016-5085 [Print] United States
• PMID: 1955122 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Piperidines
• Serotonin Antagonists
• Cisapride

Topics

• Child
• Child, Preschool
• Cisapride
• Double-Blind Method
• Duodenum (drug effects, physiopathology)
• Eating (physiology)
• Female
• Gastric Emptying (drug effects)
• Gastrointestinal Motility (drug effects)
• Humans
• Infant
• Intestinal Pseudo-Obstruction (blood, drug therapy, physiopathology)
• Male
• Manometry
• Piperidines (blood, pharmacology, therapeutic use)
• Serotonin Antagonists (blood, pharmacology, therapeutic use)