A Double‐Blind Controlled Trial on the Effect of Cisapride in the Treatment of Constipation in Paraplegic Patients

Abstract

The present double‐blind controlled study compared with a crossover design, the efficacy of cisapride with that of placebo in the treatment of constipation in 10 paraplegic patients. The trial consisted of a 5‐week run‐in period and two 12‐week test periods, separated by a 4‐week washout period. Total and segmental large‐bowel transit times were assessed by means of radiopaque markers during the last week of the run‐in and of the two test periods. Bowel frequency during run‐in, placebo, and cisapride periods was, respectively, 2.9 · 2, 4.1 · 3, and 3.6 · 2.7 evacuations per week (NS). Neither the use of laxatives nor the modality of evacuation changed among the study periods. Oro‐anal transit time during run‐in, placebo, and cisapride periods was, respectively, 146 · 45, 93 · 49 (p < 0.01 vs. run‐in), and 103 · 53 h (p < 0.02 vs. run‐in; NS vs. placebo). The measurement of the large‐bowel segmental transit times showed that transit through the right colon, left colon, and rectum did not differ during the three study periods. In conclusion, cisapride at the dosage of 10 mg four times a day was no more effective than placebo in improving bowel frequency and oro‐anal or segmental large‐bowel transit times in paraplegic patients.