Cisapride, in Patients with Non-Ulcer Dyspepsia

Objective: This study was undertaken to determine whether H. pylori infection has an effect on the improve-ment of dyspeptic symptoms in response to a prokinetic agent, cisapride, in patients with non-ulcer dyspep-sia (NUD). Material and Method: 35 NUD patients (16 M, 19 F) who had no underlying medical condition and negative upper endoscopy were included in the present study. Each patient received a 2-wk treatment of cisapride (Prepulsid®, 10 mg, tid ac). H. pylori infection was determined using a rapid urease test (CLO test®). Gastric emptying (GE) scintigraphy and dyspeptic symptom scores were evaluated before and at the end of the treatment. GE was evaluated in 22 healthy volunteers as normal controls. Results: Half time (T1/2) GE of NUD patients was 90.9 + 28 min which was significantly longer than controls (77.6 + 14 min; p < 0.05) and was shortened to 73.6 + 22 min (p < 0.0001) at the end of the treatment. Cisapride significantly improved total dyspeptic symptom scores [7 (2-18) to 3 (0-11), p < 0.0001]. The symptom score improvement was not affected by H. pylori infection [H. pylori positive: 6 (2-18) to 2.5 (0-9), p < 0.0001; H. pylori negative: 9 (4-16) to 3 (0-11), p < 0.0001] or GE status [delayed GE: 10 (5-16) to 3 (1-5), p < 0.05; non delayed GE: 6 (2-18) to 2 (0-11); p < 0.0001]. Conclusions: Cisapride improves dyspeptic symptoms regardless of H. pylori and GE status. These results suggest that gastric emptying and H. pylori infection are not essential to determine prior to prescribing a prokinetic agent, cisapride, in patients with NUD