| Abstract | dc.description.abstract | OBJECTIVES: Altered small-bowel motility, lengthening of
the orocecal transit time, and small-intestinal bacterial overgrowth
have been described in patients with liver cirrhosis.
These changes might be related to the progressive course
and poor prognosis of the disease. We investigated the effect
of a long-term treatment with cisapride and an antibiotic regimen
on small-intestinal motor activity, orocecal transit time,
bacterial overgrowth, and some parameters of liver function.
METHODS: Thirty-four patients with liver cirrhosis of different
etiology entered in the study. They were randomly
allocated to receive cisapride (12), an alternating regimen of
norfloxacin and neomycin (12), or placebo (10) during a
period of 6 months. At entry and at 3 and 6 months, a
stationary small-intestinal manometry was performed, and
orocecal transit time and small-intestinal bacterial overgrowth
were also investigated using the H2 breath test. Liver
function was estimated with clinical and laboratory measurements
(Child-Pugh score).
RESULTS: After 6 months, both cisapride and antibiotics
significantly improved fasting cyclic activity, reduced the
duration of orocecal transit time, and decreased small-intestinal
bacterial overgrowth. Cisapride administration was followed
also by an increase in the amplitude of contractions. No
statistically significant variations in these parameters were observed
with placebo. An improvement of liver function was
observed at 3 and 6 months with both cisapride and antibiotics.
CONCLUSIONS: Long-term treatment with cisapride or antibiotics
reversed altered small-intestinal motility and bacterial
overgrowth in patients with liver cirrhosis. These findings
suggest a possible role for prokinetics and antibiotics as
a modality of treatment in selected cases of decompensated
cirrhosis. | en_US |
