Controlled study of cisapride-assisted lavage preparatory to colonoscopy.
BACKGROUND
Traditional bowel preparation before colonoscopy involves lavage with approximately 4 L of polyethylene-glycol (PEG)-electrolyte solution. Using prokinetic agents in addition to PEG-electrolyte lavage may decrease the volume required and ease patient preparation.


METHODS
We conducted a blinded, placebo-controlled trial with the prokinetic agent, cisapride, in addition to standard PEG-electrolyte lavage. Patients were prospectively assigned to receive 20 mg of cisapride (n = 52) or placebo (n = 49) 30 minutes before drinking PEG-electrolyte solution. The volume consumed, time to clean bowel, side effects, and acceptance were recorded. Adequacy of colon cleaning was scored by a gastroenterologist blinded to group assignment.


RESULTS
Thirty-seven percent of patients assigned to cisapride required more than 3500 mL of PEG-electrolyte, compared with 75% of patients receiving placebo (p < 0.001). Median time to clean bowel was 95 minutes for the cisapride group and 120 minutes for those receiving placebo (p = 0.23). Side effects, patient acceptance, and quality of bowel preparation were not significantly different.


CONCLUSIONS
We conclude that administration of 20 mg of cisapride reduces the required volume of PEG-electrolyte solution for bowel preparation. There were also favorable trends in the time required to achieve clean bowel, patient tolerance, and occurrence of side effects.
Lazarczyk
D A
DA
Department of Internal Medicine, McLaren Regional Medical Center, Flint, Michigan, USA.
Stein
A D
AD
Courval
J M
JM
Desai
D
D
D000368:Aged; D020117:Cisapride; D003113:Colonoscopy / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D011446:Prospective Studies; D007507:Therapeutic Irrigation / Q000379:methods*; D013995:Time
D005765:Gastrointestinal Agents; D010880:Piperidines; D020117:Cisapride