Manabe N, Cremonini F, Camilleri M, Sandborn WJ, Burton DD
Effects of bisacodyl on ascending colon emptying and overall colonic transit in healthy volunteers. [JOURNAL ARTICLE]
Aliment Pharmacol Ther 2009 Aug 12.
Background and
Aim: The mechanism of action of bisacodyl in the unprepared human colon is unclear. Our aim was to evaluate the effect of oral bisacodyl on the overall and regional colonic transit in humans.
Methods: In a double-blind, randomized, placebo-controlled study of 25 healthy participants, effects of oral bisacodyl (5mg p.o. per day) and placebo on colonic transit were compared. Validated scintigraphy using (111)In-charcoal delivered to the ileocolonic region in a delayed- release capsule was used to measure colonic transit. The primary transit endpoints, ascending colon emptying (AC) t(1/2) and geometric center (GC) of colon isotope at 24 hours (overall transit), were compared (Wilcoxon rank sum test).
Results: There were significant treatment effects on AC t(1/2), with the bisacodyl group demonstrating accelerated emptying [median 6.5 h, interquartile range (IQR) 5.0 - 8.0 h] relative to the placebo group [11.0 h (7.0 - 17.1)], P=0.03]. Numerical differences in colonic GC 24 hours [bisacodyl median 3.0 (2.2 - 3.8), placebo 4.0 (3.1 - 4.6)] were not significant (P=0.19). There were no significant differences observed in GC 4 hours.
Conclusion: Oral 5mg bisacodyl accelerates AC in the unprepared colon in healthy adults; this action may contribute to the drug's efficacy in constipation.
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