Use of Cisapride in Treatment of Constipation in Children

Odeka, E. B.; F, Sagher; Miller, Vivien; Doig, Caroline M.

doi:10.1097/00005176-199708000-00012

Cited by 26 publications

(18 citation statements)

References 14 publications

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“…We also observed changes in the patterns of colonic dysmotility toward normal patterns or exclusive involvement of distal colonic portions (Table 3) and fecaloma emptying, neutralizing the phrenocolonic reductive effect on the proximal motility of the digestive tube. 8,11,12 Only one study analyzed orocecal transit time during treatment and did not show its reduction, 24 in opposition to our data, which showed a decrease in this parameter using both lactulose and bean test meal. It is worth mentioning that dysmotility of the proximal digestive tube may be associated with symptoms in the upper abdomen, such as early saciety, which may disappear after fecaloma emptying.…”

Section: Discussioncontrasting

confidence: 99%

“…It is worth mentioning that dysmotility of the proximal digestive tube may be associated with symptoms in the upper abdomen, such as early saciety, which may disappear after fecaloma emptying. 6,8,10,12 Regarding total and segmental colonic transit times, it is difficult to compare our results with the few studies found in the literature, considering that distinct therapy regimens 14,16,24,25 or patients with constipation associated with neurological involvement were analyzed. 15 Regarding our patients with clinical symptoms improved upon Our data also show a higher probability of laxative need after 1 year of treatment in patients with persistence of delayed total colonic transit time at the sixth week of treatment, underscoring the importance of the initial phase of treatment.…”

Section: Discussionmentioning

confidence: 99%

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Efeito do tratamento convencional da constipação crônica funcional no tempo de trânsito orocecal e colônico total e segmentar

Soares¹,

Tahan²,

Morais³

2009

J. Pediatr. (Rio J.)

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No conflicts of interest declared concerning the publication of this article. Methods: A total of 34 consecutive patients with functional constipation attending a specialized outpatient clinic were included in the study. Total and segmental colonic transit times were assessed using radiopaque markers. Hydrogen breath test was used to evaluate lactulose and bean orocecal transit times. Treatment consisted of disimpaction, general and dietary fiber intake instruction, and mineral oil administration.Results: At admission, colonic dysmotility was found in 71.9% (23/32) of patients. All patients who complied with the treatment showed improvement of clinical symptoms after 6 weeks of treatment, when 82.6% (19/23) of those with dysmotility at admission returned to normal or reduced the severity of colonic transit patterns. Transit time decreased (medians) between admission and eighth week of treatment: lactulose orocecal transit (from 70 to 50 minutes, p = 0.002), bean orocecal transit (from 240 to 220 minutes, p = 0.002), and total colonic transit (from 69.5 to 37.0 hours, p = 0.001). The need for mineral oil therapy for constipation after a 12-month treatment was associated with persistence of total colonic transit higher than 62 hours at the eighth week of treatment (p = 0.014). Conclusion:The conventional therapeutic approach yielded good results regardless of the presence or not of colonic dysmotility at inclusion in the study. Digestive tract motility abnormalities in functionally constipated children may be reversed, and may be secondary to constipation.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efeito do tratamento convencional da constipação crônica funcional no tempo de trânsito orocecal e colônico total e segmentar

Soares¹,

Tahan²,

Morais³

2009

J. Pediatr. (Rio J.)

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“…Tempo de trânsito e constipação -Soares AC et al Quanto ao tempo de trânsito colônico total e segmentar, é difícil a comparação de nossos resultados com os poucos estudos da literatura, considerando que foram avaliados esquemas terapêuticos diferentes 14,16,24,25 ou pacientes com constipação associada com comprometimento neurológico 15 . Em nossos pacientes com boa evolução clínica com o esquema terapêutico prescrito, é possível especular que tenha ocorrido redução das dimensões colônicas, o que poderia contribuir para a normalização de sua função peristáltica.…”

Section: Discussionunclassified

Effects of conventional treatment of chronic

Soares¹,

Tahan²,

Morais³

2009

J Pediatr (Rio J)

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Objective: To evaluate the effects of conventional treatment of chronic functional constipation on total and segmental colonic transit times and on orocecal transit time.Methods: A total of 34 consecutive patients with functional constipation attending a specialized outpatient clinic were included in the study. Total and segmental colonic transit times were assessed using radiopaque markers. Hydrogen breath test was used to evaluate lactulose and bean orocecal transit times. Treatment consisted of disimpaction, general and dietary fiber intake instruction, and mineral oil administration.Results: At admission, colonic dysmotility was found in 71.9% (23/32) of patients. All patients who complied with the treatment showed improvement of clinical symptoms after 6 weeks of treatment, when 82.6% (19/23) of those with dysmotility at admission returned to normal or reduced the severity of colonic transit patterns. Transit time decreased (medians) between admission and eighth week of treatment: lactulose orocecal transit (from 70 to 50 minutes, p = 0.002), bean orocecal transit (from 240 to 220 minutes, p = 0.002), and total colonic transit (from 69.5 to 37.0 hours, p = 0.001). The need for mineral oil therapy for constipation after a 12-month treatment was associated with persistence of total colonic transit higher than 62 hours at the eighth week of treatment (p = 0.014). Conclusion:The conventional therapeutic approach yielded good results regardless of the presence or not of colonic dysmotility at inclusion in the study. Digestive tract motility abnormalities in functionally constipated children may be reversed, and may be secondary to constipation. J Pediatr (Rio J). 2009;85(4):322-328:Gastrointestinal transit, constipation, therapy, pediatrics. ResumoObjetivo: Avaliar o efeito do tratamento convencional da constipação crônica funcional no tempo de trânsito colônico total e segmentar e no tempo de trânsito orocecal. Métodos:Foram incluídos 34 pacientes com constipação funcional atendidos consecutivamente em ambulatório especializado. O tempo de trânsito colônico total e segmentar foi avaliado com marcadores radiopacos. O tempo de trânsito orocecal da lactulose e do feijão foi avaliado com teste do hidrogênio no ar expirado. O tratamento constou de desimpactação, orientações gerais e de consumo de dieta rica em fibra alimentar e administração de óleo mineral.Resultados: Na admissão, dismotilidade colônica foi encontrada em 71,9% (23/32) dos pacientes. Todos os pacientes que realizaram corretamente o tratamento apresentaram melhora clínica na sexta semana do tratamento quando 82,6% (19/23) daqueles com dismotilidade na admissão apresentaram normalização ou diminuição da gravidade no padrão de trânsito colônico. Observou-se redução do tempo de trânsito (medianas) entre a admissão e a oitava semana de tratamento: trânsito orocecal da lactulose (de 70 para 50 minutos, p = 0,002), orocecal do feijão (de 240 para 220 minutos, p = 0,002) e colônico total (de 69,5 para 37,0 horas, p = 0,001). A necessidade de uso de ...

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“…Initially, Staiano et al [29] showed, in 20 children randomized either to cisparide, 0.2 mg/kg three times daily, or placebo, for a 12-week period, that cisapride significantly increased stool frequency, and decreased laxative use and transit time. Later, Odeka et al [30] randomized 37 children either to cisparide, 0.2 mg/kg three times daily, or to placebo, for an 8-week period, and no significant differences were shown. Halabi [28] completed a randomized trial in which 69 patients received either cisapride at 0.3 mg/kg four times daily or placebo and found significant differences between stool frequency as well as improved gastrointestinal transit.…”

Section: Cisapridementioning

confidence: 99%

“…No differences were reported in the final numbers when comparing cisapride with placebo, most likely related to a lack of power. As can be appreciated, three groups of authors have shown cisapride to be effective [7•,28,29], whereas one did not [30]. The reason for the discrepancy is not clear, but it is possible that the dose and duration in the trial that showed no differences were suboptimal, as some patients may respond to doses of 0.3 mg/kg three times a day [7•,28].…”

Section: Cisapridementioning

confidence: 99%

Advances in the management of pediatric constipation

Nurko

2000

Curr Gastroenterol Rep

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Constipation in children is a common concern. There is no single treatment; many children do not respond and continue to have chronic problems. This lack of response is multifactorial, but it is most likely related to the fact that the exact pathophysiology of constipation in children is not known. Diagnostic criteria (Rome II classification) and algorithms proposed by the North American Society for Pediatric Gastroenterology and Nutrition (NASPGN) for evaluation and treatment of children with constipation were recently published and are summarized here. The effectiveness of new treatments such as dietary interventions, prokinetic agents, biofeedback, and polyethylene-glycol electrolyte (PEG) solutions is discussed in this review.

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Use of Cisapride in Treatment of Constipation in Children

Abstract: This study did not demonstrate a clinical role for the use of cisapride in the treatment of idiopathic constipation in children.

Cited by 26 publications

References 14 publications

Efeito do tratamento convencional da constipação crônica funcional no tempo de trânsito orocecal e colônico total e segmentar

Efeito do tratamento convencional da constipação crônica funcional no tempo de trânsito orocecal e colônico total e segmentar

Effects of conventional treatment of chronic

Advances in the management of pediatric constipation

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