Controlled study of cisapride-assisted lavage preparatory to colonoscopy

• Published in: Gastrointestinal endoscopy Vol. 48; no. 1; pp. 44 - 48
• Main Authors: Lazarczyk, Dariusz A., Stein, Aryeh D., Courval, Jeanne M., Desai, Dilip
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.1998; Elsevier
• Subjects: Aged; Biological and medical sciences; Cisapride; Colonoscopy - methods; Digestive system; Double-Blind Method; Female; Gastrointestinal Agents - adverse effects; Gastrointestinal Motility - drug effects; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Piperidines - adverse effects; Piperidines - pharmacology; Piperidines - therapeutic use; Prospective Studies; Therapeutic Irrigation - methods; Time; Ethylene oxide polymer; Human; Evaluation; Cisapride; Association; Colonoscopy; Placebo; Clinical trial; Endoscopy; Biological activity; Antiemetic; Enema
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/S0016-5107(98)70127-0

Background: Traditional bowel preparation before colonoscopy involves lavage with approximately 4 L of polyethylene-glycol (PEG)-electrolyte solution. Using prokinetic agents in addition to PEG-electrolyte lavage may decrease the volume required and ease patient preparation. Methods: We conducted a blinded, placebo-controlled trial with the prokinetic agent, cisapride, in addition to standard PEG-electrolyte lavage. Patients were prospectively assigned to receive 20 mg of cisapride (n = 52) or placebo (n = 49) 30 minutes before drinking PEG-electrolyte solution. The volume consumed, time to clean bowel, side effects, and acceptance were recorded. Adequacy of colon cleaning was scored by a gastroenterologist blinded to group assignment. Results: Thirty-seven percent of patients assigned to cisapride required more than 3500 mL of PEG-electrolyte, compared with 75% of patients receiving placebo ( p < 0.001). Median time to clean bowel was 95 minutes for the cisapride group and 120 minutes for those receiving placebo ( p = 0.23). Side effects, patient acceptance, and quality of bowel preparation were not significantly different. Conclusion: We conclude that administration of 20 mg of cisapride reduces the required volume of PEG-electrolyte solution for bowel preparation. There were also favorable trends in the time required to achieve clean bowel, patient tolerance, and occurrence of side effects. (Gastrointest Endosc 1998;48:44-8.)