THE EFFECT OF A SINGLE RECTAL DOSE OF CISAPRIDE ON DELAYED GASTRIC-EMPTYING

Background: Cisapride has an established prokinetic effect in patients with delayed gastric emptying. However, rectal administration of the drug might be preferred in patients with either dysphagia or nausea du e to gastroparesis. Aim: To determine the effect of a single rectal do se of cisapride 60 mg on gastric emptying in patients with delayed gas tric emptying. Methods: Thirty-two patients (16 males, 16 females) wit h demonstrated delayed gastric emptying received a single dose of two suppositories containing either cisapride (2 x 30 mg) or placebo, acco rding to a double-blind randomized crossover design. Three hours after administration of the suppositories, the patients received a radio-la belled test meal and radio-opaque markers for measurement of gastric e mptying. Results: The mean t(1/2) after cisapride administration (76 m in, 95% CI: 68-95) was significantly shorter (P = 0.005; n = 28, per-p rotocol analysis) than after placebo administration (104 min, 81-126). Four hours after ingestion of the meal significantly fewer radio-opaq ue markers remained in the stomach after cisapride than after placebo administration (P < 0.05). Mild to moderate adverse events, mainly inv olving the gastrointestinal tract, were reported in 10 patients (31%) after cisapride treatment and in four patients (13%) after placebo (N. S,; n = 32). Conclusion: A single suppository dose of cisapride 60 mg significantly accelerates gastric emptying of the solid phase of a mea l and of radio-opaque markers in patients with previously demonstrated delayed gastric emptying.