Effect of cisapride on chronic idiopathic constipation in children

The efficacy of cisapride, a new prokinetic drug, as a treatment for chronic functional constipation of childhood was studied in 20 constipated children. Each subject had a stool frequency less than 4/week and/or total gastrointestinal transit time >33 hr and was randomly assigned to double-blind treatment with either cisapride (N=10) or placebo (N=10) for 12 weeks. Stool habits, total gastrointestinal transit time, and anorectal motility were evaluated in all children before and at the end of the treatment period. Cisapride significantly increased stool frequency from 1.2±0.6 to 5.1±1.9 stools/week (mean±SD;P<0.05), whereas the lesser effect of placebo was not significant (1.2±0.8 to 2.8±0.8 stools/weeks;P=0.4). Both treatments significantly (P<0.05) decreased laxative or suppository use. Total gastrointestinal transit time was decreased by cisapride (90.8±9.2 hr to 57.2±20.2 hr;P<0.05) but was not affected by placebo. Anorectal manometry showed that cisapride, but not placebo, significantly decreaed the rectoanal inhibitory reflex threshold and the conscious rectal sensitivity threshold. It is concluded that cisapride improves gastrointestinal motility and bowel habits in children with cronic idiopathic constipation and may be useful in the management of some children with this disorder.