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Use of cisapride in treatment of constipation in children
E B Odeka1, F Sagher, V Miller
1Department of Paediatric Gastroenterology, Booth Hall Childrens Hospital (University of Manchester), England.
Insights
Cisapride did not improve stool frequency or gastrointestinal transit time in children with chronic constipation. This study found no clinical benefit for cisapride in treating idiopathic constipation in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
Background:
- Chronic constipation affects a significant number of children.
- Idiopathic constipation in children presents a management challenge.
Purpose of the Study:
- To evaluate the efficacy of cisapride in treating idiopathic constipation in children.
- To assess the impact of cisapride on stool frequency and gastrointestinal transit time.
Main Methods:
- A double-blind, placebo-controlled study involving 37 children with chronic constipation.
- Treatment with cisapride (0.2 mg/kg t.d.s.) or placebo for 8 weeks after initial laxative treatment for impaction.
- Measurement of total gastrointestinal and orocaecal transit times before and after treatment.
Main Results:
- Cisapride treatment did not lead to improvements in stool frequency compared to placebo.
- No significant changes in total gastrointestinal transit time were observed with cisapride.
- Orocaecal transit time also remained unaffected by cisapride administration.
Conclusions:
- The study failed to demonstrate a clinical benefit of cisapride for pediatric idiopathic constipation.
- Cisapride does not appear to be an effective treatment option for this condition in children.
Background:
Chronic constipation is a common problem in children. We observed the effects of cisapride in the management of idiopathic constipation in children.
Methods:
Thirty-seven children with a history of constipation (i.e., pain and difficulty or delay in defecation for > 3 months) were recruited and randomly assigned to 8 weeks of treatment with either cisapride, 0.2 mg/kg three times daily, or matching placebo after a 2-week run-in period in a double-blind, parallel-group study design. In phase 1 (2 weeks), patients had plain abdominal radiographs to assess degree of faecal load, and those with impaction were given laxatives. After satisfactory clearance of faeces, total gastrointestinal transit time and orocaecal transit time were measured. In phase 2, after 8 weeks of treatment with either cisapride or placebo (0.2 mg/kg t.d.s.), the transit studies were repeated.
Results:
Compared with placebo, cisapride did not improve either stool frequency or transit time in this study population.
Conclusion:
This study did not demonstrate a clinical role for the use of cisapride in the treatment of idiopathic constipation in children.