Effects of cisapride on antral area and fullness during intraduodenal lipid infusion

Abstract

Recent studies suggest that the beneficial effects of cisapride on gastrointestinal symptoms may be related to changes in proximal stomach or antral tone. Intraduodenal (ID) lipid induces fullness and suppresses phasic antral pressure waves; effects on antral area have not been assessed. In 10 healthy subjects, aged 20-29yr, antral area and fullness was measured on two separate days before, during and after ID lipid infusion. Cisapride (I 0mg tid) or placebo was given for four days before each test, in random, double-blind, crossover fashion. On each day 0.9% saline was infused into the duodenum (2ml/min) for 30min, followed by 10% Intralipid (triglyceride emulsion) (2.2kcallmin) for 120min. Measurements of antral area (ultrasound) and perception of fullness (visual analog scale) were made at 15 min intervals, commencing 15min prior to the ID saline infusion. Fasting antral area tended to be less on cisapride when compared to placebo (2.98:t0.4cm2 vs 3.8:t0.4cm2; P= O.l l). ID lipid increased antral area with both cisapride and placebo (P< O.OI), and the magnitude of this increase was greater (P<0.05) with cisapride (figure). ID lipid increased fullness (P< 0.05) with no difference between cisapride and placebo. We conclude that: (i) ID lipid increases antral area and (ii) cisapride accentuates this increase. Data are mean values :t SEM.