Document Detail


Effects of cisapride in patients with cystic fibrosis and distal intestinal obstruction syndrome.
MedLine Citation:
PMID:  2231217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a double-blind, placebo-controlled, crossover trial, we investigated the effects of the prokinetic drug cisapride in patients with cystic fibrosis and chronic recurrent distal intestinal obstruction syndrome (DIOS). After a baseline period, 17 patients (12.9 to 34.9 years; 12 boys) received, in random order, cisapride (7.5 to 10 mg) and placebo three times daily by mouth, each for 6 months. Gastrointestinal symptoms (flatulence, abdominal pain, fullness, abdominal distension, nausea, anorexia, heartburn, diarrhea, vomiting and regurgitation) were scored three times monthly and physical examinations assessed. At baseline and at each 6-month period, assessment included food intake for 7 days, 3-day stool collection, pulmonary function tests, and abdominal radiographs. During cisapride therapy compared with placebo, there were significant reductions in flatulence (p less than 0.005), fullness, and nausea (p less than 0.05). Patients with the worst symptom scores benefited most from cisapride. With cisapride, 12 patients felt better and three worse (p less than 0.05); physicians judged 11 patients improved and two worse (p less than 0.05). No side effects were noted. There were no significant differences between cisapride and placebo periods in nutritional status, x-ray scores, pulmonary function, food intake (fat, protein, calories), stool size and consistency, and fecal losses of fat, bile acids, chymotrypsin, and calories. For acute episodes of DIOS, intestinal lavage was needed 6 times in 4 patients during treatment with cisapride, and 11 times in 6 patients receiving placebo. In comparison with unselected patients with cystic fibrosis and pancreatic insufficiency who were receiving enzyme supplements and who had no distal intestinal obstruction, fecal fat losses (percentage of intake) were almost twice as high in the study group with DIOS (31.2 +/- 20.6% vs 16.2 +/- 17.6%; p less than 0.01). We conclude that in the dosage used, long-term treatment with cisapride appears to improve chronic abdominal symptoms in patients with cystic fibrosis and DIOS, but fails to abolish the need for intestinal lavage. Cisapride treatment had no effect on digestion and nutritional status of cystic fibrosis patients with pancreatic insufficiency.
Authors:
S Koletzko; M Corey; L Ellis; M Spino; D A Stringer; P R Durie
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  117     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1990 Nov 
Date Detail:
Created Date:  1990-12-07     Completed Date:  1990-12-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  815-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Chronic Disease
Cisapride
Cystic Fibrosis / complications,  diagnosis,  drug therapy*
Double-Blind Method
Female
Humans
Intestinal Obstruction / diagnosis,  drug therapy*,  etiology
Male
Piperidines / therapeutic use*
Recurrence
Serotonin Antagonists / therapeutic use*
Syndrome
Chemical
Reg. No./Substance:
0/Piperidines; 0/Serotonin Antagonists; 81098-60-4/Cisapride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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