The effect of cisapride on segmental colonic transit time in patients with spinal cord injury.
OBJECTIVE
The pathophysiological consequences of spinal cord injury (SCI) on function of the colon are complex and poorly understood. Regardless of the mechanism, many patients with SCI have deficient bowel control, which is frustrating and difficult to treat. We designed a study to assess whether a new prokinetic medication, cisapride, might be useful in this setting.


METHODS
Total and segmental colonic transit time were measured using the radiopaque marker technique in nine subjects with spinal cord injury and seven control subjects after the double-blind administration of cisapride (10 mg q.i.d.) or placebo.


RESULTS
In five quadriplegic subjects with prolonged colonic transit time, administration of cisapride was found to reduce left-sided colonic transit time from 24.2 to 13.8 h. In three of these five subjects, cisapride administration resulted in subjective improvement. No effect of cisapride on right-sided, rectosigmoid, or total colonic transit time was observed.


CONCLUSIONS
The data suggest that cisapride might be a useful adjunctive measure in treating a subset of SCI patients with colonic inertia, but a larger study is needed before this can be routinely recommended.
Section of Gastroenterology, Bronx VA Medical Center, New York, New York.
J M
JM
Geders
A
A
Gaing
W A
WA
Bauman
M A
MA
Korsten
D000328:Adult; D000368:Aged; D020117:Cisapride; D003106:Colon / Q000187:drug effects* / Q000503:physiopathology; D003248:Constipation / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000494:pharmacology* / Q000627:therapeutic use; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D013566:Sympathomimetics / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome
D010880:Piperidines; D013566:Sympathomimetics; D020117:Cisapride