Effect of cisapride on gastric sensitivity to distension, gastric compliance and duodeno-gastric reflexes in healthy humans

Background and aims. Visceral hypersensitivity and impaired gastric relaxat ion after the ingestion of a meal are frequent features in patients with fu nctional dyspepsia. Cisapride improves dyspeptic symptoms. The study aims t o evaluate whether cisapride influences gastric sensitivity to distension a s well as gastric compliance and duodenogastric reflexes. Patients and methods. Eight healthy males were studied on two different day s, each after 7 days' treatment either with placebo or cisapride 10 mg qid in randomized order. A spherical bag connected to a barostat was placed in the gastric fundus and an B-lumen manometric catheter was positioned with 4 side holes in antrum and 4 in duodenum. During a phase II of the migrating motor complex, the intragastric bag was inflated at a constant pressure I mm Hg above the intra-abdominal pressure and the gastric volume was measure d during intraduodenal infusion of lipids and citric acid at different rate s. Once the stomach returned to the basal volume, the bag was distended acc ording to two different protocols until subjects reported discomfort. Antro duodenal motility was measured throughout the study. Results. Intraduodenal infusion of lipids and citric acid caused relaxation of gastric fundus. Relaxation was similar for lipids and acid (203 +/- 30 vs 199 +/- 43 ml), and was not influenced by cisapride and infusion rate. C isapride did not influence gastric sensitivity to distension (10 +/-1.5 vs 9.7 +/-1.3 mm Hg) and gastric compliance (52.7 +/-1.2 vs 49.8 +/-1.8 ml/mm Hg). The antral motor index significantly decreased following infusion of a cid and lipids with placebo but not with cisapride. Conclusions. Cisapride inhibits the physiological duodenoantral reflexes bu t does not influence either the mechanical properties of the gastric fundus nor the gastric sensitivity to distension.