Update from the Canadian Dyspepsia Working Group
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* Sander Zanten
* Nigel Flook
* Naoki Chiba
* David Armstrong
* Alan Barkun
* Marc Bradette
* Alan Thomson
* Ford Bursey
* Patricia Blackshaw
* Dawn Frail
* Paul Sinclair

In our recently published *CMAJ* supplement on the management of uninvestigated dyspepsia in the era of *Helicobacter pylori,*1 we (on behalf of the Canadian Dyspepsia Working Group) made a very cautious statement about the use of cisapride, given the increasing number of publications that have recently described rare but potentially serious cardiac consequences associated with use of this drug. Cisapride was listed as a third option in the minimanagement schema for gastroesphageal reflux disease (Fig. 3)1 and was also listed as a third option in the treatment schema for patients who have a negative result of noninvasive diagnostic testing for* H. pylori*. Given the cardiac side effects of cisapride use, both the Health Protection Branch and the US Food and Drug Administration have decided that cisapride should be withdrawn from the market and only released following special authorization for selected individuals. Given these recent changes in the availability of cisapride, the Canadian Dyspepsia Working Group feels that we can no longer recommend this medication for the treatment of gastroesophageal reflux disease or for the treatment of dyspepsia that is *H. pylori* negative. 

## Reference

1.  1. Veldhuyzen van Zanten SJO, Flook N, Chiba N, Armstrong D, Barkun A, Bradette M, Thomson A, Bursey F, Blackshaw P, Frail D, Sinclair P, for the Canadian Dyspepsia Working Group. An evidence-based approach to the management of uninvestigated dyspepsia in the era of *Helicobacter pylori*. *CMAJ* 2000;162(12 Suppl):S1-S23.