The Effects of Cisapride on Bile Reflux Gastritis

Kim, Jeong Kwon; Moon, Chi Young; Lee, Jae Kyeong; Kim, Dae Gon; Moon, Woo Sung

Abstract

BACKGROUND/AIMS
It was reported that a new gastrokinetic drug, cisapride, increased the antral and duodenal motility index and then, reduced high bile salt reflux. The purpose of this study was to determine whether the administration of cisapride could improve the degree of bile reflux and the histological changes of gastric mucosa in patients with bile reflux gastritis. METHODS: Twenty patients were enrolled in this study. They were administered cisapride 30 mg b.i.d before meals for 8 weeks. Endoscopic examination, gastric mucosal biopsy, and measurement of bile acid concentration from the gastric aspirate were performed before and 8 weeks after drug administration. The histological changes of gastric mucosa were graded according to the Whitehead classification system and the symptomatic responses to the treatment were assessed during follow-up. RESULTS: Mean concentration of intragastric total bile acid for the all 20 patients with bile reflux was significantly higher than that for controls (559.23+/-427.56 micromol/L vs 62.54+/-64.33, p=0.001). In patients, the administration of cisapride significantly decreased the concentration of intragastric bile acid (599.23+/-427.56 vs 293.69+/-395.98 micromol/L, p=0.001). The histological grade and the gastrointestinal symptoms were in part significantly (p<0.05) improved after drug administration. CONCLUSIONS: These results suggest that administration of cisapride to patients with chronic gastritis decreases duodenogastric bile reflux, improve histological grade of gastritis, and subsequently ameliorates gastrointestinal symptoms associated with bile reflux.