piperidines and Colonic-Pseudo-Obstruction

Ogilvie's syndrome or acute pseudo-obstruction of the colon is characterized by a massive colonic dilatation in the absence of any mechanical obstruction. It is a particular syndrome of adynamic ileus. This case report describes a patient with Ogilvie's syndrome; he has been treated with cisapride and colonoscopic decompression.

Topics: Aged; Cisapride; Colonic Pseudo-Obstruction; Colonoscopy; Combined Modality Therapy; Decompression, Surgical; Female; Gastrointestinal Agents; Humans; Piperidines

Topics: Cisapride; Colonic Pseudo-Obstruction; Female; Humans; Middle Aged; Parasympathomimetics; Piperidines; Seizures; Serotonin Antagonists

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Cisapride; Colonic Pseudo-Obstruction; Decompression; Erythromycin; Female; Humans; Parasympathomimetics; Parenteral Nutrition; Piperidines

Acute pseudobstruction of the colon (Ogilvie's syndrome) has been treated by different surgical, endoscopic and radiological procedures, but a high proportion of recurrences has been reported. Here, we report two cases that showed a fast and favorable response to oral cisapride, a prokinetic agent that may become the treatment of choice for these patients.

Topics: Acute Disease; Aged; Cisapride; Colonic Pseudo-Obstruction; Female; Humans; Male; Parasympathomimetics; Piperidines; Remission Induction

Topics: Acute Disease; Cisapride; Colonic Pseudo-Obstruction; Erythromycin; Guanethidine; Humans; Neostigmine; Piperidines; Serotonin Antagonists

Topics: Acute Disease; Adult; Cisapride; Colonic Pseudo-Obstruction; Humans; Male; Piperidines; Serotonin Antagonists; Syndrome

We report on one patient in whom segmental colic intestinal pseudo-obstruction (IPO) following the surgical treatment of a grade III necrotising enterocolitis (NEC) was responsible for a severe failure to thrive. Further intestinal resection in an already short gut was avoided by using Cisapride, a new intestinal prokinetic agent (1 mg/kg/d in 4 doses, orally), which dramatically improved the symptoms and allowed weight gain and intestinal adaptation. After 6 months, Cisapride was withdrawn. IPO did not recur after 2 years of follow-up, although proximal distention persisted.

Topics: Cisapride; Colonic Pseudo-Obstruction; Enteral Nutrition; Enterocolitis, Pseudomembranous; Follow-Up Studies; Humans; Ileostomy; Infant; Infant, Newborn; Infant, Premature, Diseases; Male; Piperidines; Postoperative Complications; Serotonin Antagonists

Topics: Aged; Cisapride; Colonic Pseudo-Obstruction; Female; Humans; Intestinal Pseudo-Obstruction; Male; Piperidines; Serotonin Antagonists

A 73-yr-old white woman admitted with lobar pneumonia and congestive heart failure developed progressive colonic pseudoobstruction (Ogilvie's syndrome) 2 days after admission which was unrelieved by diatrizoate meglumine (Gastrografin, Squibb Canada, Montreal) enema and rectal tube. Cisapride, a new gastrointestinal prokinetic agent, was administered intravenously with full resolution of the syndrome. To the authors' knowledge, this is the first reported case of successful treatment of acute colonic pseudoobstruction with cisapride.

Topics: Acute Disease; Aged; Cisapride; Colonic Diseases; Colonic Pseudo-Obstruction; Drug Evaluation; Drugs, Investigational; Female; Humans; Infusions, Intravenous; Intestinal Pseudo-Obstruction; Piperidines; Serotonin Antagonists; Time Factors

The action of cisapride on physiological and disturbed gastrointestinal motor function was investigated in conscious and anesthetized dogs and the mechanism of action involved. Regardless of the presence or absence of vagal innervation, administration of cisapride (0.2 mg approximately 1.0 mg/kg body weight, i.v.) during the quiescent period of interdigestive migrating contractions (IMC), induced non-migrating IMC-like motility in the entire gastrointestinal tract from gastric body to distal colon. Administration of cisapride in the digestive state resulted in the excitatory response of increased amplitude of digestive peristalsis and strong IMC-like motility was not observed. All of these excitatory responses in gastrointestinal motility disappeared by the administration of atropine (0.5 mg approximately 0.1 mg/kg body weight, i.v.). Furthermore, the excitatory response in gastrointestinal motility induced by cisapride in anesthetized dogs disappeared by the administration of TTX (10 micrograms/kg of body weight, i.v.). These results suggest that the excitatory action of cisapride on the gastrointestinal motility is based on its mechanism in which cisapride acts on the cholinergic neurones in the gastrointestinal wall to stimulate ACh release, resulting in the increase in gastrointestinal motility. Cisapride caused powerful IMC-like motility in the ileum of animal with pseudo-obstruction-like motor disturbance which had been seen after preparation of Thiry loop (ileum). This motility migrated from the proximal ileum to the Thiry loop and then to the distal ileum. Trimebutine maleate also demonstrated this effect, but metoclopramide and domperidone were ineffective. Administration of cisapride at the doses (0.2 mg approximately 1.0 mg/kg body weight, i.v.) causing stimulated motor response in the gastrointestinal tract did not induce significant secretion of gastric acid, pancreatic juice and bile.

Topics: Animals; Cholinergic Fibers; Cisapride; Colonic Pseudo-Obstruction; Digestive System; Digestive System Physiological Phenomena; Dogs; Gastrointestinal Motility; Parasympathomimetics; Piperidines