Controlled study of cisapride-assisted lavage preparatory to colonoscopy

Background: Traditional bower preparation before colonoscopy involves lavage with approximately 4 L of polyethylene-glycol (PEG)-electrolyte solution. Using prokinetic agents in addition to PEG-electrolyte lavage may decrease the volume required and ease patient preparation. Methods: We conducted a blinded, placebo-controlled trial with the prokinetic agent, cisapride, in addition to standard PEG-electrolyte lavage. Patients were prospectively assigned to receive 20 mg of cisapride (n = 52) or placebo (n = 49) 30 minutes before drinking PEG-electrolyte solution. The volume consumed, time to clean bower, side effects, and acceptance were recorded. Adequacy of colon cleaning was scored by a gastroenterologist blinded to group assignment. Results: Thirty-seven percent of patients assigned to cisapride required more than 3500 mL of PEG-electrolyte, compared with 75% of patients receiving placebo (p < 0.001). Median time to clean bowel was 95 minutes for the cisapride group and 120 minutes for those receiving placebo (p = 0.23). Side effects, patient acceptance, and quality of bowel preparation were not significantly different. Conclusion: We conclude that administration of 20 mg of cisapride reduces the required volume of PEG-electrolyte solution for bower preparation.There were also favorable trends in the time required to achieve clean bowel, patient tolerance, and occurrence of side effects.