High-resolution manometry reveals different effect of polyethylene glycol, bisacodyl and prucalopride on colonic motility in healthy subjects: an acute, open label, randomised, crossover, reader blinded study with potential clinical implications

Corsetti, Maura; Thys, Alexander; Harris, Alexander; Pagliaro, Giuseppe; Deloose, Eveline; Demedts, Ingrid; Tack, Jan

Abstract

PEG, bisacodyl and prucalopride have been reported to be more effective than placebo in treating patients with constipation but about 50% of the patients still do not respond to these medications. Only bisacodyl and pucalopride are expected to directly stimulate the colonic motility in humans in vivo. As no previous study has done this, the aim of the study was to investigate the effect of PEG, bysacodyl and prucalopride as compared to placebo on colonic motility assessed by means of the high-resolution manometry (HRM) in healthy subjects.
Methods: 10 healthy subjects have been enrolled in an acute, open-label, randomized, reader-blinded, cross-over study and requested to undergo a colonoscopy-assisted HRM measuring their colonic motility before and after administration of 13.8 g (two doses) PEG, 10 mg bisacodyl, 2 mg prucalopride and placebo.
Results: in the human prepared colon, oral administration of PEG significantly increases the number of low amplitude long distance propagating contractions (P= 0.007 vs placebo) while bisacodyl significantly increases the number of high amplitude propagating contractions (HAPCs) (all P[less than]0.01 vs PEG, prucalopride and placebo). Prucalopride has no major effect on the number of propagating contractions but increases HAPCs amplitude (P= 0.01) and seems to increase the number of simultaneous pressure increases.
Conclusions: In humans, PEG, prucalopride and bisacodyl have distinct effects on colonic motility in humans. This information has clinical implication, as it indicates that the combination of prucalopride and bisacodyl, normally not considered in clinical practice, could be effective in treating patients with constipation refractory to single medications.

Citation

Corsetti, M., Thys, A., Harris, A., Pagliaro, G., Deloose, E., Demedts, I., & Tack, J. (2021). High-resolution manometry reveals different effect of polyethylene glycol, bisacodyl and prucalopride on colonic motility in healthy subjects: an acute, open label, randomised, crossover, reader blinded study with potential clinical implications. Neurogastroenterology and Motility, 33(5), Article e14040. https://doi.org/10.1111/nmo.14040

• Journal Article Type: Article
• Acceptance Date: Nov 2, 2020
• Online Publication Date: Dec 10, 2020
• Publication Date: 2021-05
• Deposit Date: Nov 6, 2020
• Publicly Available Date: Dec 11, 2021
• Journal: Neurogastroenterology and Motility
• Print ISSN: 1350-1925
• Electronic ISSN: 1365-2982
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 33
• Issue: 5
• Article Number: e14040
• DOI: https://doi.org/10.1111/nmo.14040
• Public URL: https://nottingham-repository.worktribe.com/output/5020645
• Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/nmo.14040
• Additional Information: This is the peer reviewed version of the following article: Corsetti, M., Thys, A., Harris, A., Pagliaro, G., Deloose, E., Demedts, I. and Tack, J. (2020), High‐resolution manometry reveals different effect of polyethylene glycol, bisacodyl, and prucalopride on colonic motility in healthy subjects: An acute, open label, randomized, crossover, reader‐blinded study with potential clinical implications. Neurogastroenterology & Motility e14040, which has been published in final form at https://doi.org/10.1111/nmo.14040. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.