Esophagoprotective potential of cisapride. An additional benefit for gastroesophageal reflux disease (original) (raw)
Related papers
Gut, 1990
The effect of cisapride, a new gastrointestinal prokinetic drug, on oesophageal motility and acid reflux was studied in 14 children with gastro-oesophageal reflux disease, receiving either placebo or cisapride 0-15 mg/kg intravenously. Cisapride significantly (p<001) increased the lower oesophageal sphincter pressure (+124%), the amplitude (+84%) and duration (+24%) of oesophageal peristaltic waves, whereas the placebo treatment did not produce any changes. Subsequently, all 14 children underwent 24 hour oesophageal pHmonitoring before and after four weeks of treatment with oral cisapride 0-2 mg/kg tid given in addition to postural therapy and thickened feedings. The 24 hour intraoesophageal pH recordings and symptomatic scores were compared with those of 10 control patients treated only by postural therapy and thickened feedings. When compared with baseline pH data, cisapride significantly reduced the oesophageal acid exposure time, the mean duration of each reflux episode, the duration of the longest reflux episode and the number of long lasting reflux episodes; the number of reflux episodes was not influenced. The effect of cisapride was marked and consistent during fasting and sleep periods. Oesophageal acid exposure was reduced more significantly in patients given cisapride (-61%) than in controls (-24%
Cisapride for gastro-oesophageal reflux and peptic oesophagitis
Archives of Disease in Childhood, 1987
Twenty children (age range 75 days-47 months) with reflux oesophagitis entered a random double blind trial in which they received either Cisapride (Janssen Pharmaceutical Ltd), a new prokinetic agent, or an identical placebo syrup. Diagnosis of gastro-oesophageal reflux was made by measurement of intraluminal oesophageal pH combined with manometry. Oesophagitis was assessed in all patients by histological examination of mucosal specimens taken during oesophagogastroduodenoscopy. Manometry, pH test, and endoscopy with biopsy examination were repeated at the end of the treatment period. Seventeen patients completed the trial, eight of whom were taking the drug and nine the placebo. Mean total clinical score and post-prandial reflux time (% of reflux) significantly improved in patients in the group given Cisapride but not in the group given placebo. Furthermore, there was a significant improvement of the histological oesophagitis score only in the children in the group given Cisapride, whereas placebo was ineffective. It is concluded that Cisapride is a useful agent both for the relief of symptoms of gastro-oesophageal reflux and for the healing of peptic oesophagitis in infancy.
Alimentary Pharmacology & Therapeutics, 1998
Background:The electrogastrogram (EGG), which records gastric myoelectrical activity, is abnormal in one‐third of adult patients with non‐ulcer dyspepsia (NUD).Aim:To observe the effects of cisapride on EGG in adults with NUD.Methods:Twenty‐seven NUD patients who had undergone a pre‐ and post‐prandial EGG were entered into an open study. All patients completed a dyspepsia symptom questionnaire and were then treated with cisapride 10 mg t.d.s. The dyspepsia questionnaire was repeated in all those completing 4 weeks of treatment. Those with an initial abnormal EGG (< 70% of slow wave activity at 2–4 cycles per minute) had a repeat EGG at the end of the study.Results:Treatment with cisapride was associated with a significant improvement in the post‐prandial EGG (P = 0.007). After 4 weeks of treatment, 7 of 13 abnormal EGGs normalized. Symptom scores improved significantly in the 13 patients with an abnormal EGG who completed treatment (P < 0.0003), but not in NUD patients with a ...
Role of Saliva in Esophageal Defense: Implications in Patients With Nonerosive Reflux Disease
The American journal of the medical sciences, 2015
It has been previously demonstrated that patients with reflux esophagitis exhibit a significant impairment in the secretion of salivary protective components versus controls. However, the secretion of salivary protective factors in patients with nonerosive reflux disease (NERD) is not explored. The authors therefore studied the secretion of salivary volume, pH, bicarbonate, nonbicarbonate glycoconjugate, protein, epidermal growth factor (EGF), transforming growth factor alpha (TGF-α) and prostaglandin E2 in patients with NERD and compared with the corresponding values in controls (CTRL). Salivary secretion was collected during basal condition, mastication and intraesophageal mechanical (tubing, balloon) and chemical (initial saline, acid, acid/pepsin, final saline) stimulations, respectively, mimicking the natural gastroesophageal reflux. Salivary volume, protein and TGF-α outputs in patients with NERD were significantly higher than CTRL during intraesophageal mechanical (P < 0.0...
Journal of Paediatrics and Child Health, 2000
Analysis 1.2. Comparison 1 Main analysis for cisapride versus no treatment, Outcome 2 Mean daily regurgitations.. Analysis 1.3. Comparison 1 Main analysis for cisapride versus no treatment, Outcome 3 Mean daily weight gain.. . Analysis 1.4. Comparison 1 Main analysis for cisapride versus no treatment, Outcome 4 Reflux index.. .. .. Analysis 1.5. Comparison 1 Main analysis for cisapride versus no treatment, Outcome 5 Adverse events.. .. .. Analysis 2.1. Comparison 2 Main analysis for cisapride versus Gaviscon, Outcome 1 'Worse, same or slight improvement' versus 'moderate or excellent improvement'.
Diseases of the Esophagus, 2003
Cisapride is a potent third generation prokinetic agent acting on postganglionic receptors by increasing the release of acetylcholine. In a prospective, self-controlled study the prokinetic action of cisapride was tested on pedicled stomach, jejunum and colon grafts used for substitute after esophageal resection. Between 1995 and 1998 15 patients with gastric pull up, 10 patients with colon replacement or bypass and eight patients with free jejunum transplant or jejunum replacement were evaluated. Esophageal transit scintigraphy was performed before and after cisapride administration. From the time-activity curves, the half-life of radiolabeled bolus in the esophagus was calculated and preadministration and postadministration half-lives were compared. Cisapride significantly reduced the half-life of radiolabeled bolus in the substitute in the case of stomach and jejunum replacement, while for colon replacement the results were dispersed too widely to yield significant difference. Cisapride exerts prokinetic effect on pedicled stomach and jejunum substitutes after esophageal resection.
2005
Objectives. The aim of the study was to define the role of bile acids (BA), accompanied by HCl−Pepsin (HCl/P/BA), in stimulation of salivary secretory response mediated by the esophagosalivary reflex. Material and Methods. The rate of secretion of salivary inorganic (bicarbonate, non−bicarbonate) and organic (protein, glycoconjugate, prostaglandin E2 – PGE2, epidermal growth factor – EGF) protective components was investigated in 19 control subjects and 18 patients with gastroesophageal reflux disease (GERD) under basal con− ditions, mastication, and during intraesophageal mechanical (tubing, balloons) and chemical stimulation (HCl/Pepsin/BA) mimicking the duodenogastroesophageal reflux (DGER). Results. The significantly increased rates of salivary bicarbonate (p < 0.05) and nonbicarbonate (p < 0.05) secre− tion, accompanied by a significant increase in pH and protein (p < 0.05) in controls during HCl/P/BA stimulation were demonstrated. In patients with GERD, nonbicarbonate...
Action of cisapride on rat colonic secretion
Naunyn-Schmiedeberg's Archives of Pharmacology, 1993
The stimulating effect of cisapride on the motility of the digestive tract is well known. However, there are only a few studies on the influence of this drug on the absorptive or secretory activity of the colonic mucosa. In the present study, the ability of cisapride to alter the mural transport of water and electrolytes in the colon and its effects on mucus secretion and albumin permeation were studied• The effects of cisapride on the rat colon in vivo were studied under different conditions, by means of an instillation of sodium acetate solution at pH 6.9, which induced absorption of water and electrolytes, and in two models of colonic secretion, one employing the instillation of an acetic acid solution at pH 2.9 and the other, an intravenous infusion of 5-hydroxytryptamine (serotonin) 45 ~g. kg-1. min-1 together with intracolonic instillation of sodium acetate. Cisapride (i.v.), at a dose of 0.32mg.kg-~, in rats whose colon was instilled with sodium acetate (pH 6.9) induced an increase in sodium absorption and a reduction in water absorption. Cisapride (i.v.), at doses of 0.32, 0.64 and 1.0 mg • kg-1, inhibited the secretion of water, Na + , CI-, and mucus and the permeation of albumin induced by acetic acid instillation or by serotonin infusion. It is concluded that the effect of cisapride on the colonic mucosa varies in accordance with the functional mucosal conditions and that this action may be of clinical importance.