The effect of cisapride on intestinal transit

Cisapride is known to accelerate gastrointestinal motility in various diseases with gastrointestinal motor abnormalities, and in normal subjects. In this study, we developed a new method to evaluate intestinal transit by radio-opaque markers, and evaluated the effect of oral doses of cisapride on intestinal transit in 6 normal subjects. Twenty markers were ingested with breakfast, and abdominal X-ray pictures were taken at 6, 24, 48 and 72 hours later, markers on the films were scored according to estimated their location. Geometric mean of the markers and half-dose transit-time (HT) at selected points of the colon were calculated. Cisapride 7.5 mg, 15 mg per day or placebo were given in random order, in double blind fashion. Cisapride accelerated intestinal transit at every point calculated. HT at anus was shortened to 23.3±10.2 hours (mean+SD) (p<0.05) with cisapride 15 mg/day from 42.3±16.9 hours with placebo. Geometric means at 24-hour were 3.7±1.4 with placebo, 5.3±0.9 (p<0.05) with cisapride 7.5 mg/day, and 5.1±1.5 with cisapride 15 mg/day. No serious side effects were noted. Our new method to evaluate intestinal transit using radio-opaque markers is easy to perform, and is able to quantify the state of transit. Cisapride accelerated intestinal transit without diarrhea. This effect of cisapride on intestinal transit may be useful in patients with constipation.