Efficacy of cisapride in the treatment of epigastric pain and concomitant symptoms in non-ulcer dyspepsia.

Non-ulcer dyspepsia is gaining increasing interest among gastroenterologists even though the pathogenetic mechanisms in individual patients are still unknown. On the basis of a number of studies, it can be concluded that in about 60% of patients impairment of gastric evacuation may contribute to the symptomatology (epigastric pain, postprandial fullness, early satiety, bloating, nausea and vomiting). This review summarizes the results of 10 placebo-controlled trials which evaluated the effects of cisapride (3 x 5 or 3 x 10 mg/day) in strict non-ulcer dyspepsia or functional postprandial dyspepsia. In seven of the trials, cisapride proved significantly superior to placebo in relieving epigastric pain and concomitant symptoms in patients with non-ulcer dyspepsia. In the three studies examining chronic functional dyspepsia, belching, postprandial bloating, early satiety and heartburn were significantly improved. In all 10 trials, cisapride was significantly superior to placebo.