Cisapride improves nicotine-evoked antral hypomotility in smokers

It has recently been shown that nicotine administration reduces antral motor function. The aim of this study was to test whether cisapride administration can improve nicotine-evoked antral hypomotility in humans. Eight healthy smoking volunteers were selected for the study. After an overnight fast, manometric recordings and electrogastrographic recordings were performed before and after the ingestion of a mixed solid meal. The measurements (manometric and electrogastrographic protocols) were carried out on two separate days. In each protocol, the measurements were made under three different conditions on three separate days; a placebo day, a nicotine day [nicotine patch (14 mg/day)], and a nicotine plus cisapride day (the nicotine patch and 5 mg cisapride) in a crossover randomized design. The number of antral phase III complexes, antral phase III motility indexes (the sum of the highest of all antral phasic contractions > 10 mmHg in 10 min), and postprandial antral motility indexes (the sum of the highest of all antral phasic contractions > 10 mmHg for the duration of 30 min) were significantly lower on the nicotine day than on the placebo day (P < 0.01, P < 0.05, and P < 0.01). However, the values obtained on the nicotine plus cisapride day were significantly higher in comparison with those obtained on the nicotine day (P < 0.05, P < 0.05, and P < 0.01) and were similar to those obtained on the placebo day (P = 0.92, P = 0.79, and P = 0.36). The frequency stability index (maximal signal amplitude for a given 2-minute recording segment occurring at a frequency of > or = 2 cycle/min and < or = 4 cycle/min) was similar on the placebo day, the nicotine day, and the nicotine plus cisapride day in both the fasting (P = 0.69) and postprandial periods (P = 0.22). These results indicate that (a) transdermal nicotine administration reduces antral gastric motor function without modification of slow wave rhythmicity and (b) cisapride administration improves nicotine-evoked antral hypomotility.