Efficacy of Cisapride on Gastric Emptying and Dyspeptic Symptoms in Patients with Gastroparesis

Cisapride, a new prokinetic devoid of anti-dopaminergic properties, acts by enhancing release of acetycholine from the myenteric plexus. To evaluate the effect of cisapride on gastric emptying and dyspeptic symptoms, a randomized placebo-controlled study was done. Twenty-six dyspeptic patients with gastric stasis (17 with chronic idiopathic dyspepsia (CID) and 9 with diabetes, mellitus (DM)) were included. Solid meal radioisotope technique using Tc-99m sulfur colloid labeled-eggs, was used to determine gastric emptying. Fourteen patients (9 CID, 5 DM were treated with cisapride 10mg tid orally for four weeks, while the other 12 patients (8 CID, 4 DM) served as the control. Symptoms were evaluated at baseline and after 2 and 4 weeks of treatment. The gastric emptying study was repeated at the end of the study. Our results showed that cisapride was significantly superior to placebo in accelerating gastric emptying halftime (p=0.002) and in relieving symptoms of epigastric fullness, epigastric pain, anorexia and early satiety (p＜0.05). This study showed that cisapride is a useful gastrokinetic for dyspeptic patients with upper gut dysmotility.