Double-blind study of the effect of cisapride on constipation and abdominal discomfort as components of the irritable bowel syndrome.
OBJECTIVE
To study the effect of prokinetic treatment with cisapride in patients with constipation-predominant irritable bowel syndrome.


METHODS
Ninety-six patients were randomly assigned to treatment with either cisapride 5 mg three times daily or placebo three times daily for a period of 12 weeks. The dosage could be doubled after 4 weeks. Presence of the target symptoms abdominal pain, constipation and abdominal bloating was an obligatory criterion for inclusion in the study.


RESULTS
After 12 weeks of treatment, 31%, 56% and 27% of the cisapride treated patients were found to be without the three target symptoms (P < 0.05). The corresponding percentages for the placebo-treated patients were 31%, 58% and 19%, respectively, (P < 0.05). The visual analogue scale (VAS) symptom scores assessed by the patients for global rating of bowel disease, general well-being and frequency of stool passage improved significantly within each treatment group (P < 0.05). Evaluation of efficacy parameters using intention-to-treat analysis showed no statistically significant differences between the groups. Using efficacy analysis, the difficulty of stool passage showed a significantly higher improvement with cisapride (P < or = 0.05).


CONCLUSIONS
These results indicate that cisapride is not superior to placebo in the treatment of constipation and abdominal discomfort as components of irritable bowel syndrome. It may, however, be of use in improving the difficulty of stool passage.
Schütze
K
K
Medical Department I, Hanusch Hospital, Vienna, Austria.
Brandstätter
G
G
Dragosics
B
B
Judmaier
G
G
Hentschel
E
E
D015746:Abdominal Pain / Q000188:drug therapy* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D020117:Cisapride; D003109:Colonic Diseases, Functional / Q000150:complications / Q000188:drug therapy*; D003248:Constipation / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*
D010880:Piperidines; D020117:Cisapride