Cisapride in treatment of roux-en-Y syndrome

Vandermijle, Hcj; Beekhuis, H; Bleichrodt, R. P.; Kleibeuker, Jan H.

doi:10.1007/bf01296611

Cited by 8 publications

(2 citation statements)

References 17 publications

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“…[75] In other studies, administration of cisapride following major abdominal surgery did not cause earlier passage of flatus [76,77] and had no effect on nausea and vomiting in the early postoperative phase.l 7S ] Cisapride was superior to placebo in alleviating symptoms following Roux-en-Y gastrojejunostomy. [79] Its efficacy in post-cholecystectomy syndromes is unclear. [80,SI] …”

Section: Postoperative Ileus and Postoperative Syndromesmentioning

confidence: 99%

A Risk-Benefit Assessment of Cisapride in the Treatment of Gastrointestinal Disorders

1995

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Cisapride is a substituted benzamide compound that stimulates motor activity in all segments of the gastrointestinal tract by enhancing the release of acetylcholine from the enteric nervous system. Cisapride is administered orally in the treatment of gastro-oesophageal reflux disease, functional dyspepsia, gastroparesis, chronic intestinal pseudo-obstruction syndromes and chronic constipation. In gastro-oesophageal reflux disease in both adults and children, cisapride provides symptomatic improvement and mucosal healing. Long term treatment with cisapride is effective in the prevention of relapse of oesophagitis. Cisapride improves gastric emptying rates and improves symptoms in patients with gastroparesis of various origins. Unlike domperidone and metoclopramide, long term administration of cisapride seems to result in persistently enhanced gastric emptying. Cisapride is also effective in improving symptoms in patients with functional dyspepsia. In comparative studies in patients with functional dyspepsia, cisapride was at least as effective as metoclopramide, domperidone, clebopride, ranitidine and cimetidine. Cisapride increases stool frequency and reduces laxative consumption in patients with idiopathic constipation. Severe cases of slow transit constipation seem refractory to cisapride. Clinical studies also indicate that cisapride might be effective in the treatment of chronic intestinal pseudo-obstruction, postoperative ileus, peptic ulcer and irritable bowel syndrome. Further clinical studies are warranted to define the role of cisapride in these conditions. The dosage of cisapride ranges from 5mg 3 times daily to 20mg twice daily. Cisapride is generally well tolerated, both during short and long term treatment. In children, cisapride is also well tolerated in doses of 0.2 to 0.3 mg/kg, 3 to 4 times daily.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Postoperative Ileus and Postoperative Syndromesmentioning

confidence: 99%

A Risk-Benefit Assessment of Cisapride in the Treatment of Gastrointestinal Disorders

1995

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“…[10][11][12][13][14][15] Cisapride has also been shown to be beneficial in patients with Roux limb stasis or gastroparesis after Rouxen-Y gastrojejunostomy. 16 For medium-and long-term management of gastroparesis in general, cisapride has become the treatment of choice. 17 The routine dose of cisapride is 10 to 20 mg four times daily (usually given 30 minutes before meals and at bedtime) and peak levels are obtained in 2 hours.…”

Section: Cisapridementioning

confidence: 99%

Management of the Patient with Gastroparesis

Rabine

Barnett

2001

Journal of Clinical Gastroenterology

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Gastroparesis may be related to a variety of underlying disorders, but management options are fairly universal. Dietary measures and pharmacologic agents, primarily in the form of prokinetic medications, form the foundation of standard management. Some patients will have refractory symptoms and alternative dosing schemes or drug combinations may be used. An occasional patient will still require venting gastrostomy and/or jejunal feeding. This review addresses the standard dietary and pharmacologic approaches to gastroparesis, as well as issues pertaining to gastrostomy/jejunostomy tubes and to surgical options for refractory cases. Finally, experimental agents and techniques, such as gastric pacing, will be discussed.

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Transit disorders of the gastric remnant and Roux limb after Roux-en-Y gastrojejunostomy: Relation to symptomatology and vagotomy

Vandermijle

Beekhuis

Bleichrodt

et al. 1993

Journal of British Surgery

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Patients after Roux-en-Y gastrojejunostomy frequently complain of upper abdominal pain, fullness, nausea and vomiting. This study was performed to clarify the relationship of this Roux-en-Y syndrome to transit disorders in the gastric remnant and Roux limb, and to vagal status. Using a questionnaire, 35 of 66 patients operated on between 1976 and 1987 were judged to suffer from the Roux syndrome. Gastrojejunal transit was studied by scintigraphy with a solid test meal in 61 patients, 34 of whom were symptomatic. The median (interquartile range) gastric half-emptying time was longer in symptomatic than in asymptomatic patients (79 (43-146) versus 56 (27-79) min, P < 0.05), and in patients with a bilateral vagotomy than in those without a vagotomy (94 (43-225) versus 59 (31-77) min, P < 0.05). Stasis in the Roux limb was observed in 18 of 28 symptomatic and in only three of 27 asymptomatic patients (P < 0.01). The median (interquartile range) fraction of activity emptied from the stomach and remaining in the Roux limb at 60 min was 54 (39-60) per cent in symptomatic patients and 33 (21-40) per cent in those without symptoms (P < 0.01). Stasis in the Roux limb was not related to vagal status. No relationship between slow gastric emptying and Roux-limb stasis was found. Slow gastric emptying, Roux-limb stasis or a combination of both was found in 30 of 34 symptomatic and in only nine of 27 asymptomatic patients (P < 0.01). It is concluded that both slow gastric emptying and Roux-limb stasis can be interpreted as causing the Roux syndrome. Vagotomy seems to be the major cause of slow gastric emptying, but it is not related to stasis in the Roux limb.

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Cisapride in treatment of roux-en-Y syndrome

Abstract: with cisapride long-lasting symptomatic relief and improved transit is achieved in about 40% of patients with the Roux-en-Y syndrome.

Cited by 8 publications

References 17 publications

A Risk-Benefit Assessment of Cisapride in the Treatment of Gastrointestinal Disorders

A Risk-Benefit Assessment of Cisapride in the Treatment of Gastrointestinal Disorders

Management of the Patient with Gastroparesis

Transit disorders of the gastric remnant and Roux limb after Roux-en-Y gastrojejunostomy: Relation to symptomatology and vagotomy

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