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. 1989 Sep;30(9):1187–1193. doi: 10.1136/gut.30.9.1187

Effect of cisapride on postprandial gastro-oesophageal reflux.

R H Holloway 1, J Downton 1, B Mitchell 1, J Dent 1
PMCID: PMC1434249  PMID: 2680794

Abstract

We studied the effect of cisapride on oesophageal motor function and postprandial gastro-oesophageal reflux in a randomised, double blind, placebo controlled crossover study. In 16 patients with symptomatic gastro-oesophageal reflux, cisapride 10 mg orally and placebo were studied on separate days according to identical protocols. Cisapride and placebo were given 30 minutes before a standard meal. Each study day was preceded by corresponding three day oral loading of cisapride (10 mg tds) or placebo. Lower oesophageal sphincter pressure, oesophageal body motility and oesophageal pH were monitored for 30 minutes before and three hours after the meal. Plasma cisapride concentrations were measured before and after dosing on both study days. With cisapride treatment, the plasma cisapride levels ranged from 48.1 (5.0) to 75.9 (6.9) ng/ml. Plasma levels were undetectable during placebo treatment. Cisapride enhanced acid clearance but had no significant effect on the duration of acid exposure, the rate of reflux episodes, the pattern of lower oesophageal sphincter pressure associated with the reflux episodes, basal lower oesophageal sphincter pressure or oesophageal peristalsis. These findings do not suggest a major role for cisapride, at the dosage tested, for the control of troublesome postprandial gastro-oesophageal reflux.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baldi F., Bianchi Porro G., Dobrilla G., Iascone C., Lobello R., Marzio L., Sabbatini F., Tittobello A., Verme G. Cisapride versus placebo in reflux esophagitis. A multicenter double-blind trial. J Clin Gastroenterol. 1988 Dec;10(6):614–618. doi: 10.1097/00004836-198812000-00007. [DOI] [PubMed] [Google Scholar]
  2. Ceccatelli P., Janssens J., Vantrappen G., Cucchiara S. Cisapride restores the decreased lower oesophageal sphincter pressure in reflux patients. Gut. 1988 May;29(5):631–635. doi: 10.1136/gut.29.5.631. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Collins B. J., Spence R. A., Ferguson R., Laird J., Love A. H. Cisapride: influence on oesophageal and gastric emptying and gastro-oesophageal reflux in patients with reflux oesophagitis. Hepatogastroenterology. 1987 Jun;34(3):113–116. [PubMed] [Google Scholar]
  4. Cucchiara S., Staiano A., Capozzi C., Di Lorenzo C., Boccieri A., Auricchio S. Cisapride for gastro-oesophageal reflux and peptic oesophagitis. Arch Dis Child. 1987 May;62(5):454–457. doi: 10.1136/adc.62.5.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dent J., Dodds W. J., Friedman R. H., Sekiguchi T., Hogan W. J., Arndorfer R. C., Petrie D. J. Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects. J Clin Invest. 1980 Feb;65(2):256–267. doi: 10.1172/JCI109667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dent J., Dodds W. J., Sekiguchi T., Hogan W. J., Arndorfer R. C. Interdigestive phasic contractions of the human lower esophageal sphincter. Gastroenterology. 1983 Mar;84(3):453–460. [PubMed] [Google Scholar]
  7. Dodds W. J., Dent J., Hogan W. J., Helm J. F., Hauser R., Patel G. K., Egide M. S. Mechanisms of gastroesophageal reflux in patients with reflux esophagitis. N Engl J Med. 1982 Dec 16;307(25):1547–1552. doi: 10.1056/NEJM198212163072503. [DOI] [PubMed] [Google Scholar]
  8. Galmiche J. P., Brandstätter G., Evreux M., Hentschel E., Kerstan E., Kratochvil P., Reichel W., Schütze K., Soule J. C., Vitaux J. Combined therapy with cisapride and cimetidine in severe reflux oesophagitis: a double blind controlled trial. Gut. 1988 May;29(5):675–681. doi: 10.1136/gut.29.5.675. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gilbert R. J., Dodds W. J., Kahrilas P. J., Hogan W. J., Lipman S. Effect of cisapride, a new prokinetic agent, on esophageal motor function. Dig Dis Sci. 1987 Dec;32(12):1331–1336. doi: 10.1007/BF01296657. [DOI] [PubMed] [Google Scholar]
  10. Gudmundsson K., Johnsson F., Joelsson B. The time pattern of gastroesophageal reflux. Scand J Gastroenterol. 1988 Jan;23(1):75–79. doi: 10.3109/00365528809093851. [DOI] [PubMed] [Google Scholar]
  11. Holloway R. H., Blank E., Takahashi I., Dodds W. J., Hogan W. J., Dent J. Variability of lower esophageal sphincter pressure in the fasted unanesthetized opossum. Am J Physiol. 1985 Apr;248(4 Pt 1):G398–G406. doi: 10.1152/ajpgi.1985.248.4.G398. [DOI] [PubMed] [Google Scholar]
  12. Horowitz M., Maddern G. J., Maddox A., Wishart J., Chatterton B. E., Shearman D. J. Effects of cisapride on gastric and esophageal emptying in progressive systemic sclerosis. Gastroenterology. 1987 Aug;93(2):311–315. doi: 10.1016/0016-5085(87)91020-1. [DOI] [PubMed] [Google Scholar]
  13. Horowitz M., Maddox A., Harding P. E., Maddern G. J., Chatterton B. E., Wishart J., Shearman D. J. Effect of cisapride on gastric and esophageal emptying in insulin-dependent diabetes mellitus. Gastroenterology. 1987 Jun;92(6):1899–1907. doi: 10.1016/0016-5085(87)90622-6. [DOI] [PubMed] [Google Scholar]
  14. Ismail-Beigi F., Horton P. F., Pope C. E., 2nd Histological consequences of gastroesophageal reflux in man. Gastroenterology. 1970 Feb;58(2):163–174. [PubMed] [Google Scholar]
  15. Janisch H. D., Hüttemann W., Bouzo M. H. Cisapride versus ranitidine in the treatment of reflux esophagitis. Hepatogastroenterology. 1988 Jun;35(3):125–127. [PubMed] [Google Scholar]
  16. Jeffries G. H. Our new president: Marvin H. Sleisenger. Gastroenterology. 1976 Jul;71(1):2–4. [PubMed] [Google Scholar]
  17. Kahrilas P. J., Dodds W. J., Hogan W. J. Effect of peristaltic dysfunction on esophageal volume clearance. Gastroenterology. 1988 Jan;94(1):73–80. doi: 10.1016/0016-5085(88)90612-9. [DOI] [PubMed] [Google Scholar]
  18. Rode H., Stunden R. J., Millar A. J., Cywes S. Esophageal pH assessment of gastroesophageal reflux in 18 patients and the effect of two prokinetic agents: cisapride and metoclopramide. J Pediatr Surg. 1987 Oct;22(10):931–934. doi: 10.1016/s0022-3468(87)80592-4. [DOI] [PubMed] [Google Scholar]
  19. Saye Z. N., Forget P. P., Geubelle F. Effect of cisapride on gastroesophageal reflux in children with chronic bronchopulmonary disease: a double-blind cross-over pH-monitoring study. Pediatr Pulmonol. 1987 Jan-Feb;3(1):8–12. doi: 10.1002/ppul.1950030105. [DOI] [PubMed] [Google Scholar]
  20. Schuurkes J. A., Van Nueten J. M., Van Daele P. G., Reyntjens A. J., Janssen P. A. Motor-stimulating properties of cisapride on isolated gastrointestinal preparations of the guinea pig. J Pharmacol Exp Ther. 1985 Sep;234(3):775–783. [PubMed] [Google Scholar]
  21. Smout A. J., Bogaard J. W., Grade A. C., ten Thije O. J., Akkermans L. M., Wittebol P. Effects of cisapride, a new gastrointestinal prokinetic substance, on interdigestive and postprandial motor activity of the distal oesophagus in man. Gut. 1985 Mar;26(3):246–251. doi: 10.1136/gut.26.3.246. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Wallin L., Kruse-Andersen S., Madsen T., Boesby S. Effect of cisapride on the gastro-oesophageal function in normal human subjects. Digestion. 1987;37(3):160–165. doi: 10.1159/000199494. [DOI] [PubMed] [Google Scholar]
  23. de Caestecker J. S., Blackwell J. N., Pryde A., Heading R. C. Daytime gastro-oesophageal reflux is important in oesophagitis. Gut. 1987 May;28(5):519–526. doi: 10.1136/gut.28.5.519. [DOI] [PMC free article] [PubMed] [Google Scholar]

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