The effects of cisapride on the quality and tolerance of colonic lavage: a double-blind randomized study

Colonic lavage is a preferred preparation for colonoscopy although this type of preparation does not always result in optimal cleansing. We postulated that cisapride, a new prokinetic agent, might improve the cleansing of the colon and ameliorate patient discomfort. Of 84 patients undergoing colonoscopy, 41 were randomized (double-blind) to Golytely plus cisapride (10 mg per OS three times during the day before the procedure and one 10-mg dose on the morning of the procedure) and 43 to Golytely plus a placebo of identical appearance. The adequacy of the preparation was scored on a five-point grading scale for each anatomic segment and for the overall impression. A questionnaire was also used to assess each patient's symptoms during lavage. The mean overall preparation score in the cisapride group was 4.0, compared with 3.7 for the placebo group ( p=.54). In the transverse colon, the mean preparation score was higher for the cisapride group (4.3 versus 3.8, p=.02). Differences in symptom scores between the two groups were not significant. In conclusion, the use of cisapride may improve visualization of the transverse colon, but it did not result in significant improvement in the overall preparation score. Changes in the dosage of cisapride should be further evaluated.