The influence of cisapride on gastric tone and the perception of gastric distension.
BACKGROUND
Delayed gastric emptying, impaired gastric accommodation to a meal and hypersensitivity to gastric distension have been implied in the pathophysiology of functional dyspepsia. Dyspeptic patients are often treated with the prokinetic drug cisapride.


OBJECTIVE
To assess the effects of cisapride on perception of gastric distension and gastric accommodation to a meal.


METHODS
Eighteen healthy volunteers underwent a gastric barostat study on two occasions, after pretreatment with placebo or cisapride 10 mg q.d.s. Graded isobaric and isovolumetric distensions were performed until the subjects reported discomfort. Volume and pressure changes were recorded and perception was scored by a questionnaire. In 10 volunteers, the amplitude of the gastric accommodation to a mixed liquid meal was also measured.


RESULTS
Pre-treatment with cisapride significantly lowered thresholds for perception and for discomfort, both during isobaric (4.3 +/- 0.7 vs. 3.2 +/- 0.7 and 12.2 +/- 1.2 vs. 9.2 +/- 0.9 mmHg above minimal distending pressure (MDP), respectively, P < 0.05) and isovolumetric (256 +/- 46 vs. 200 +/- 35 and 644 +/- 36 vs. 511 +/- 40 mL, respectively, P < 0.05) distensions. Cisapride significantly enhanced the size of the meal-induced fundus relaxation (143 +/- 37 vs. 270 +/- 50 mL, P < 0.05).


CONCLUSIONS
Cisapride enhances both the perception of gastric distension and the gastric accommodation to a meal. These data suggest that cisapride may provide benefit to patients with impaired postprandial relaxation of the fundus.
Tack
J
J
Department of Internal Medicine, University Hospital Gasthuisberg, University of Leuven, Belgium. jan.tack@med.kuleuven.ac.be
Broeckaert
D
D
Coulie
B
B
Janssens
J
J
D000328:Adult; D020117:Cisapride / Q000494:pharmacology* / Q000627:therapeutic use; D004415:Dyspepsia / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005748:Gastric Fundus / Q000502:physiology; D005765:Gastrointestinal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010465:Perception; D019518:Postprandial Period
D005765:Gastrointestinal Agents; D020117:Cisapride