Effect of long-term oral therapy with cisapride on the interdigestive antro-duodenal motility pattern in dyspeptic subjects

Cisapride has recently been reported to activate the migrating motor complex (MMC) of the interdigestive motility cycle (IDMC) after intravenous administration and to improve dyspeptic symptoms after long-term oral treatment. In order to evaluate the effect of cisapride on interdigestive antro-duodenal motility during prolonged oral therapy, ten dyspeptic subjects with motor disorders of the antro-duodenal region, documented by manometric recording, and without evidence of upper gastrointestinal tract diseases were studied. Computerized manometry of the antro-duodenal region was performed for 240 minutes, or until two consecutive MMCs had been recorded, before and during oral administration of cisapride (10 mg QID) for 15 days. Symptomatic evaluation of patients was also performed before and after treatment. On the 15th day of cisapride administration, a significant increase both in the overall incidence of MMCs (P = 0.027) and in the incidence of antral complexes (P = 0.018) was noticed; likewise, the Motility Index (MI), calculated for phase-2 periods appeared to be significantly higher (P = 0.00006). Symptomatic improvement (P = 0.011) was observed, too. We conclude that long-term therapy with oral cisapride appears markedly effective in improving antro-duodenal interdigestive motor activity as well as dyspeptic symptoms.