J Korean Acad Rehabil Med.
2001 Dec;25(6):948-955.
Effect of Combined Therapy of Cisapride and Lactulose on Neurogenic Bowel Dysfunction in Spinal Cord Injury
- Affiliations
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- 1Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Korea.
- 2Department of Radiology, College of Medicine, The Catholic University of Korea, Korea.
- 3Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Korea.
Abstract
OBJECTIVE
To calculate the colonic transit time (CTT) and to evaluate the effect of combined therapy of cisapride and lactulose on neurogenic bowel dysfunction in patients with chronic spinal cord injury. METHOD: This study was prospectively designed. Right (rCTT), left (lCTT), rectosigmoid (rsCTT), and total (tCTT) colonic transit times were measured using the radio-opaque marker technique in twenty patients with spinal cord injury (SCI group), of which mean age was 39 years (range: 13~67 years) and median duration after SCI was 15 months (4-252 months). Ten ambulatory stroke patients (mean age 49 years, median duration, 12 months) were also evaluated as control group. All CTTs in both groups were compared by unpaired Student's t-test. In SCI group, the therapeutic effect of combined administration of cisapride (10 mg p.o. t.i.d) and lactulose (134.0 g/100 ml, 30-45 ml per day p.o.) was statistically analyzed by paired Student's t-test.
RESULTS
Total (p<0.0001) and segmental CTT (p<0.01) except right colon were significantly delayed in SCI group when compared to the control group. In SCI group, tCTT of non-ambulatory patients (n=13) and rCTT, lCTT, rsCTT and total CTT of ambulatory patients (n=7) were significantly decreased after the combined drug therapy (p<0.05). In ambulatory SCI patients, duration after injury showed negative correlation with tCTT (Pearson's correlation coefficient r = 0.8407, p=0.0178).
CONCLUSION
Combined therapy of cisapride and lactulose can improve tCTT in SCI patients with neurogenic bowel dysfunction.
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