Use of Cisapride in Treatment of Constipation in Children

Background Chronic constipation is a common problem in children. We observed the effects of cisapride in the management of idiopathic constipation in children. Methods Thirty-seven children with a history of constipation (i.e.. pain and difficulty or delay in defecation for >3 months) were recruited and randomly assigned to 8 weeks of treatment with either cisapride, 0.2 mg/kg three times daily, or matching placebo after a 2-week run-in period in a double-blind, parallel-group study design. In phase 1 (2 weeks), patients had plain abdominal radiographs to assess degree of faecal load, and those with impaction were given laxatives. After satisfactory clearance of faeces, total gastrointestinal transit time and orocaecal transit time were measured. In phase 2, after 8 weeks of treatment with either cisapride or placebo (0.2 mg/kg t.d.s.), the transit studies were repeated. Results Compared with placebo, cisapride did not improve either stool frequency or transit time in this study population. Conclusion This study did not demonstrate a clinical role for the use of cisapride in the treatment of idiopathic constipation in children.