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  • 1
    Electronic Resource
    Electronic Resource
    Efficacy of cisapride therapy in functional dyspepsia (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 9 (1995), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: To assess the efficacy of cisapride therapy in relieving symptoms of functional dyspepsia. Methods: After a 2-week placebo run-in period, 61 out of 74 patients were eligible to enter a 4-week double-blind treatment phase, consisting of treatment with cisapride (10 mg) or placebo tablets t.d.s. Gastric emptying was assessed scintigraphically at entry to the study. Patients were stratified before treatment into those with or without active chronic (Helicobacter pylori) gastritis. Patients were also classified retrospectively into those with ‘reflux-like’ dyspepsia (n= 29) and those with ‘motility-like’ dyspepsia (n= 32). Results: At the end of the active treatment phase, there was a similar significant (P 〈 0.001) reduction in total symptom score from baseline in both cisapride (8.9±0.5 to 5.8±0.6) and placebo (9.7±0.6 to 5.5±0.6) groups. Scores for heartburn and continual bloating were significantly reduced in the cisapride but not the placebo group; improvement was attributable to patients with normal, rather than delayed, rates of gastric emptying. For continual bloating, significant improvement also occurred in the cisapride subgroup without gastritis, but not in the subgroup with gastritis (mean symptom score reduction 0.48±0.18, P= 0.03). For global evaluation by the investigator and by the patient, the overall improvement rates were not statistically different between cisapride and placebo groups. In those with normal gastric emptying, however, there was a significant (P= 0.01) improvement in general well-being in the cisapride but not in the placebo group. Conclusions: We were unable to show major differences in the short-term efficacy of cisapride and placebo in functional dyspepsia. There were indications, however, of beneficial effects of cisapride over placebo in those with ‘reflux-like’ dyspepsia, and in those without gastroparesis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1995.tb00364.x
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  • 2
    Electronic Resource
    Electronic Resource
    Mebeverine alters small bowel motility in irritable bowel syndrome (1996)
    Oxford BSL : Blackwell Science
    Alimentary pharmacology & therapeutics 10 (1996), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background and Aim: Despite its widespread use in irritable bowel syndrome (IBS), limited clinical data exist on the effects of mebeverine hydrochloride on gastrointestinal motility. Human motor activity in the small bowel is more reproducible than that in the large bowel; therefore the aim of this study was to determine in the small bowel the effects of oral mebeverine in both IBS patients and in healthy controls. Methods: Twelve IBS patients (11 females/ 1 male, 46±13 years old)—predominant constipation (IBS-C, n=6) and predominant diarrhoea (IBS-D, n=6)—and six healthy controls, underwent continuous 48 h ambulant recording of small bowel motor activity. One low energy (400 kcal) and one high energy (800 kcal) standard meal were administered in each consecutive 24-h period. Subjects received, in blinded fashion, placebo tablets in the first 24 h then mebeverine 135 mg q.d.s. in the second 24 h. Results: Mebeverine had no effect on parameters of small bowel motility in controls. In contrast, in both IBS-C (P=0.01) and IBS-D (P〈0.05) patients, phase 2 motility index was increased during mebeverine administration. Also, after mebeverine the proportion of the migrating motor complex cycle occupied by phase 2 was reduced in IBS-D (P=0.01), while phase 2 burst frequency was reduced in IBS-C (P〈0.05). For phase 3 motor activity in IBS-C patients, the propagation velocity was decreased (P〈0.01), and the duration increased (P〈0.01). Conclusions: These findings suggest that mebeverine, in the initial dosing period, has a normalizing effect in the small bowel in IBS, enhancing contractile activity in a similar fashion to ‘prokinetic’ agents, as well as producing alterations in motor activity consistent with an ‘antispasmodic’ effect.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.1996.61203000.x
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  • 3
    Electronic Resource
    Electronic Resource
    Effects of oral cisapride on small bowel motility in irritable bowel syndrome (1997)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 11 (1997), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cisapride has been reported to improve symptoms in patients with constipation-predominant irritable bowel syndrome.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To compare the effects of a 24-h oral dose regimen of cisapride on interdigestive and post-prandial small bowel motor activity in irritable bowel syndrome patients with predominant constipation, irritable bowel syndrome patients with predominant diarrhoea and healthy subjects.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:In 12 irritable bowel syndrome patients (11 females, aged 44 ± 12 years)—constipation-predominant (irritable bowel syndrome-C, n=5) and diarrhoea-predominant (irritable bowel syndrome-D, n=7)—and six healthy subjects, small bowel motor activity was continuously recorded using an ambulatory technique over a 48-h period. Subjects received, in single-blind fashion, placebo tablets q.d.s. in the first 24 h then cisapride 10 mg q.d.s. in the second 24 h. Additional control groups were 13 healthy subjects (eight females, aged 39 ± 13 years) and 10 irritable bowel syndrome patients (10 females, aged 49 ± 14 years) who were studied in identical fashion but who did not receive cisapride.〈section xml:id="abs1-4"〉〈title type="main"〉Results:Cisapride increased migrating motor complex phase 2 motility index in both irritable bowel syndrome-D (P 〈 0.01) and irritable bowel syndrome-C (P 〈 0.05) patients, as well as in healthy subjects (P 〈 0.01). An increase in fasting discrete clustered contractions occurred in irritable bowel syndrome-D patients (P 〈 0.001) and in healthy subjects (P 〈 0.01), but not in irritable bowel syndrome-C patients; the proportion of discrete clustered contractions that were propagated, however, increased only in irritable bowel syndrome-D patients (P 〈 0.001). In addition, cisapride resulted in an increase in post-prandial motility index in irritable bowel syndrome patients (P 〈 0.05). Such motor alterations were not observed during the 48-h recording period in the healthy or irritable bowel syndrome patient control groups who did not receive cisapride.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:Oral cisapride influences interdigestive and post-prandial small bowel motor activity in both irritable bowel syndrome patients and healthy subjects; the effects of cisapride may be more marked in patients with predominant diarrhoea than in patients with predominant constipation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.1997.00240.x
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  • 4
    Electronic Resource
    Electronic Resource
    Intragastric distribution and gastric emptying of solids and liquids in functional dyspepsia (1993)
    Springer
    Digestive diseases and sciences 38 (1993), S. 2247-2254 
    Details
    ISSN: 1573-2568
    Keywords: intragastric distribution ; gastric emptying ; functional dyspepsia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The relative contributions of altered gastric motor function andHelicobacter pylori-associated active chronic gastritis to the pathogenesis of functional dyspepsia are controversial. We therefore evaluated scintigraphically the intragastric distribution and gastric emptying of a mixed solid-liquid meal in 75 patients with functional dyspepsia; patients were subdivided on the basis of both specific symptom clusters and the presence or absence ofH. pylori gastritis. Twenty-one (28%) patients displayed abnormal solid and/or liquid gastric emptying, with prolonged solid lag time the most prominent alteration detected. The number of patients with abnormal scintigraphic patterns increased to 36 (48%) when intragastric distribution parameters (fundal half-emptying time and antral maximal fraction) were examined. Although patients with reflux-like dyspepsia (N=36) demonstrated significantly slower rates of liquid emptying at 45 and 70 min and a higher prevalence of abnormal liquid intragastric distribution when compared to patients with motility-like dyspepsia (N=39) or to controls (N-34), the absolute differences were small and unlikely to be of clinical significance. Patients withoutH. pylori gastritis (N=50) demonstrated a significantly more prolonged solid lag time when compared to those withH. pylori gastritis (N=25), but the difference was small and there were no other differences between these two subgroups. We conclude that in patients with functional dyspepsia: (1) abnormal solid gastric emptying is present in less than one third; (2) assessment of parameters of intragastric distribution enables more subtle gastric motor dysfunction to be identified; and (3) neither dividing patients into symptom subgroups nor accounting for the presence or absence ofH. pylori gastritis has a major influence on the prevalence or type of gastric motor dysfunction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01299904
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  • 5
    Electronic Resource
    Electronic Resource
    Cigarette smoking and nicotine delay postprandial mouth-cecum transit time (1992)
    Springer
    Digestive diseases and sciences 37 (1992), S. 1544-1547 
    Details
    ISSN: 1573-2568
    Keywords: cigarette smoking ; nicotine ; mouth-cecum transit
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The acute effects of both cigarette smoking and nicotine on postprandial mouth-cecum transit were studied in 20 habitual smokers, 10 males and 10 females. Mouth-cecum transit time was measured by the breath hydrogen technique, following ingestion of a standard mixed liquid meal. Each subject was studied on four separate occasions, either (1) sham or actively smoking two standard cigarettes, commencing 20 min after the meal, or (2) chewing two placebo or nicotine tablets over a 60-min period, commencing immediately after the meal. The time of administration of these stimuli was designed to minimize the effects on mouth-cecum transit time of alterations in gastric emptying. Mouth-cecum transit time was prolonged in response to both smoking [median and interquartile range: 120 (95, 150) min vs 100 (75, 140) min,P=0.01] and nicotine [120 (80, 170) min vs 100 (70, 140) min,P=0.002]. No difference was observed between sexes with respect to nicotine; the effect of smoking on mouth-cecum transit time, however, was less pronounced in females compared to males [difference active-placebo: 10 (10, 20) min vs 35 (20, 60) min,P=0.01]. We conclude that acute cigarette smoking delays mouth-cecum transit time, an effect most likely due to nicotine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01296500
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  • 6
    Electronic Resource
    Electronic Resource
    Enteric and central contributions to intestinal dysmotility in irritable bowel syndrome (1992)
    Springer
    Digestive diseases and sciences 37 (1992), S. 168-174 
    Details
    ISSN: 1573-2568
    Keywords: irritable bowel syndrome ; small intestine ; pathophysiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the study was to further elucidate the pathophysiology of irritable bowel syndrome and its subgroups by examining and comparing alterations in small bowel motility, specifically phase II and phase III components of the migrating motor complex. Prolonged recordings of interdigestive small bowel motility were obtained during both diurnal and nocturnal periods in 20 patients with irritable bowel syndrome-10 with predominant constipation and 10 with predominant diarrhea-and in 10 healthy subjects. Diurnal amplitude (mean±sd) of phase III activity fronts was lower (P〈0.05) in constipation-predominant patients (16.3±3.1 mm Hg) than in diarrhea-predominant patients (20.2±3.1) or controls (20.9±2.7). Similar findings were observed nocturnally. Phase III cycle length was also significantly prolonged diurnally in constipation-predominant patients when compared to the other groups. In the diarrhea-predominant group repetitive and rapidly propagated bursts of contractions were observed in eight patients, and this pattern occupied a significantly greater proportion of phase II motor activity than in controls. These alterations in phase II and in phase III components of the migrating motor complex suggest that both local (enteric) and more central mechanisms may operate to produce intestinal dysmotility in the irritable bowel syndrome and that these mechanisms differ according to the predominant alteration of bowel habit.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01308167
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