Lack of effect of Helicobacter pylori on symptom improvement with a prokinetic medication, cisapride, in patients with non-ulcer dyspepsia.
OBJECTIVE
This study was undertaken to determine whether H. pylori infection has an effect on the improvement of dyspeptic symptoms in response to a prokinetic agent, cisapride, in patients with non-ulcer dyspepsia (NUD).


METHODS
35 NUD patients (16 M, 19 F) who had no underlying medical condition and negative upper endoscopy were included in the present study. Each patient received a 2-wk treatment of cisapride (Prepulsid, 10 mg, tid ac). H. pylori infection was determined using a rapid urease test (CLO test). Gastric emptying (GE) scintigraphy and dyspeptic symptom scores were evaluated before and at the end of the treatment. GE was evaluated in 22 healthy volunteers as normal controls.


RESULTS
Half time (T1/2) GE of NUD patients was 90.9 +/- 28 min which was significantly longer than controls (77.6 +/- 14 min; p < 0.05) and was shortened to 73.6 +/- 22 min (p < 0.0001) at the end of the treatment. Cisapride significantly improved total dyspeptic symptom scores [7 (2-18) to 3 (0-11), p < 0.0001]. The symptom score improvement was not affected by H. pylori infection [H. pylori positive: 6 (2-18) to 2.5 (0-9), p < 0.0001; H. pylori negative: 9 (4-16) to 3 (0-11), p < 0.0001] or GE status [delayed GE: 10 (5-16) to 3 (15), p < 0.05; non delayed GE: 6 (2-18) to 2 (0-11); p < 0.0001].


CONCLUSIONS
Cisapride improves dyspeptic symptoms regardless of H. pylori and GE status. These results suggest that gastric emptying and H. pylori infection are not essential to determine prior to prescribing a prokinetic agent, cisapride, in patients with NUD.
Gonlachanvit
Sutep
S
Department of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Mahachai
Varocha
V
Chaiwatanarat
Tawatchai
T
Kullavanijaya
Pinit
P
D000328:Adult; D018679:Cholinergic Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D020117:Cisapride / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000150:complications* / Q000503:physiopathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D016896:Treatment Outcome
D018679:Cholinergic Agonists; D005765:Gastrointestinal Agents; D020117:Cisapride