EFFECTS OF CISAPRIDE ON DELAYED GASTRIC-EMPTYING AND UPPER GASTROINTESTINAL SYMPTOMS IN PATIENTS WITH CHRONIC LIVER-DISEASE - A PILOT-STUDY

Previous studies have shown that patients with chronic liver disease acid symptoms of upper gastrointestinal (GI) dysfunction have delayed gastric emptying compared with healthy subjects. This pilot study investigated the effects of the prokinetic agent cisapride (5 mg three times daily for 2 to 3 months) on gastric emptying time and upper GI symptoms such as nausea, vomiting, epigastric pain, postprandial fullness, anorexia, and weight loss in 16 patients with chronic liver disease (2 with chronic active hepatitis, 13 with chronic persistent hepatitis, and 1 with early liver cirrhosis). At study entry, gastric emptying half-time (GET,,) was longer in the treatment group (160.8 +/- 63.3 minutes, mean +/- SE) than in a healthy control group (89.4 +/- 5.9 minutes) and significantly longer in a group of patients with chronic liver disease but no upper GI symptoms (101.8 +/- 13.2 minutes; P < 0.05). In patients who received cisapride treatment, follow-up GET,, values were significantly lower (P < 0.05) than the initial baseline values (114.1 +/- 34.6 minutes and 160.8 +/- 63.3 minutes, respectively). Cisapride also significantly improved patients' upper GI symptom scores, from 6.82 +/- 2.56 at baseline to 2.75 +/- 2.41 at end of treatment (P < 0.05). The only side effect reported in patients treated with cisapride was a single case of skin rash with pruritus, which disappeared when treatment stopped. This study suggests that short-term treatment with cisapride improves upper GI symptoms in patients with chronic liver disease and impaired gastric emptying. Further studies are needed with more patients and longer treatment times.