Lack of Effect of Helicobacter pylori on Symptom Improvement with a Prokinetic Medication, Cisapride, in Patients with Non-Ulcer Dyspepsia
Sutep Gonlachanvit, MD*, Varocha Mahachai, MD*, Tawatchai Chaiwatanarat, MD**, Pinit Kullavanijaya, MD*
Affiliation : * Department of Medicine, Faculty of Medicine, Chulalongkorn University ** Department of Radiology, Faculty of Medicine, Chulalongkorn University
Objective : This study was undertaken to determine whether H. pylori infection has an effect on the improve-
ment of dyspeptic symptoms in response to a prokinetic agent, cisapride, in patients with non-ulcer dyspep-
sia (NUD).
Materials and Methods : 35 NUD patients (16 M, 19 F) who had no underlying medical condition and negative
upper endoscopy were included in the present study. Each patient received a 2-wk treatment of cisapride
(Prepulsid®, 10 mg, tid ac). H. pylori infection was determined using a rapid urease test (CLO test®). Gastric
emptying (GE) scintigraphy and dyspeptic symptom scores were evaluated before and at the end of the
treatment. GE was evaluated in 22 healthy volunteers as normal controls.
Results : Half time (T1/2) GE of NUD patients was 90.9 + 28 min which was significantly longer than controls
(77.6 + 14 min; p < 0.05) and was shortened to 73.6 + 22 min (p < 0.0001) at the end of the treatment.
Cisapride significantly improved total dyspeptic symptom scores [7 (2-18) to 3 (0-11), p < 0.0001]. The
symptom score improvement was not affected by H. pylori infection [H. pylori positive: 6 (2-18) to 2.5 (0-9),
p < 0.0001; H. pylori negative: 9 (4-16) to 3 (0-11), p < 0.0001] or GE status [delayed GE: 10 (5-16) to 3 (1-
5), p < 0.05; non delayed GE: 6 (2-18) to 2 (0-11); p < 0.0001].
Conclusions : Cisapride improves dyspeptic symptoms regardless of H. pylori and GE status. These results
suggest that gastric emptying and H. pylori infection are not essential to determine prior to prescribing a
prokinetic agent, cisapride, in patients with NUD.
Keywords : Cisapride, Gastric emptying, Helicobacter pylori, Dyspepsia
