The effect of cisapride on duodenal acid exposure in the proximal duodenum in healthy subjects.
OBJECTIVE
To investigate the effect of the prokinetic drug, cisapride, on fasting and postprandial acid exposure in the proximal duodenum.


METHODS
Using a double-blind, placebo-controlled crossover study design, 12 healthy male volunteers were studied. After 1 week of dosing (cisapride 20 mg b.d. orally or placebo), fasting and postprandial antroduodenal pH-and pressure-recordings were made. Using a small-caliber (4 mm) catheter, containing one antral and two duodenal pH electrodes, and two antral and three duodenal pressure recording sites. Transmucosal potential difference was measured to ensure proper catheter position. Infusions of 0.1 N HCl were given in the duodenal bulb.


RESULTS
Endogenous acidification of the duodenal bulb occurred more frequently during phase II and postprandially, compared to phase I (P<0.001). During phase I, alkalinization of the antrum was observed. Cisapride significantly increased the postprandial number of duodenal acidic periods (P<0.02), but shortened their duration (P<0.04). The duodenal motor response elicited by exogenous acid was lower during phase I (P<0.05).


CONCLUSIONS
Antral and proximal duodenal acidity vary with the phases of the interdigestive motor complex. Cisapride shortens the individual periods of duodenal acidification.
Verhagen
M A
MA
Gastrointestinal Motility Unit, University Hospital, Utrecht, The Netherlands. marcanne@knmg.nl
Roelofs
J M
JM
Edelbroek
M A
MA
Smout
A J
AJ
Akkermans
L M
LM
D000328:Adult; D000897:Anti-Ulcer Agents / Q000494:pharmacology*; D020117:Cisapride / Q000494:pharmacology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004386:Duodenum / Q000187:drug effects* / Q000378:metabolism; D005769:Gastrointestinal Motility; D006801:Humans; D006851:Hydrochloric Acid / Q000494:pharmacology*; D006863:Hydrogen-Ion Concentration; D008297:Male; D019518:Postprandial Period
D000897:Anti-Ulcer Agents; D006851:Hydrochloric Acid; D020117:Cisapride