The administration of cisapride as an adjuvant to PEG-electrolyte solution for colonic cleansing: a double-blind randomized study.
OBJECTIVE
Traditional bowel preparation before colonoscopy involves lavage with approximately 4L of polyethylene glycol (PEG)-electrolyte solution. Only a few studies have been published evaluating the use of cisapride in routine bowel preparation.


METHODS
We conducted a blinded, placebo-controlled trial with the prokinetic agent, cisapride, in addition to standard PEG-electrolyte lavage. Of 115 patients undergoing colonoscopy, 58 were randomized (double-blind) to PEG plus cisapride (10 mg per os thrice per day three days before the procedure and one 10-mg dose on the morning of the procedure) and 57 to PEG plus a placebo of identical appearance. The adequacy of the preparation was scored on a four-point grading scale for each anatomic-segment and for the overall impression. A questionnaire was also used to assess each patient's symptoms during lavage.


RESULTS
The difference in the overall score between the two groups was not significant (p=0.21). The quality of bowel preparation was significantly better in transverse (p=0.001), ascending (p=0.0053), and cecum (p=0.0001) in the cisapride group than in the placebo group. The differences in symptoms scores between the two groups were not significant in nausea, abdominal cramps and bloating but there was improvement in symptom score of vomiting in cisapride group (p=0.0422).


CONCLUSIONS
The administration of cisapride to patients undergoing colonic lavage may be an effective adjuvant to PEG-electrolyte solution particularly with respect to increase patient acceptability.
Katsinelos
Panagiotis
P
Department of Endoscopy and Motility Unit, General Hospital, Aristotelion University, Thessaloniki, Greece.
Pilpilidis
Ioannis
I
Paroutoglou
George
G
Xiarchos
Panagiotis
P
Tsolkas
Panagiotis
P
Papagiannis
Adreas
A
Giouleme
Olga
O
Kapelidis
Paris
P
Papageorgiou
Athanasios
A
Dimiropoulos
Stavros
S
Eugenidis
Nikos
N
D020117:Cisapride / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D003106:Colon / Q000187:drug effects / Q000473:pathology*; D003113:Colonoscopy; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004573:Electrolytes / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D012996:Solutions; D007507:Therapeutic Irrigation; D014839:Vomiting / Q000139:chemically induced
D004338:Drug Combinations; D004573:Electrolytes; D005765:Gastrointestinal Agents; D012996:Solutions; D011092:Polyethylene Glycols; D020117:Cisapride