Editor—I read with great interest the study by McClure et al 1reporting delayed gastric emptying and a non-significant increase in whole gut transit time in premature infants treated with cisapride.1 In contrast, placebo controlled studies evaluating cisapride in paediatrics have almost consistently reported improvement in symptoms of gastro-oesophageal reflux diseases or improvement in oesophageal pH results and/or manometry.2As acknowledged by the authors, other studies in premature infants have reported a reduction in gastric residue and improved feed tolerance. In addition, we have reported a reduction in gastro-oesophageal reflux in premature infants.3

In this latest trial the authors chose hydroxypropylmethyl cellulose as a placebo, given at the “same volume” as cisapride; however, the actual quantity administered is not clear. Cellulose derivatives are commonly employed as laxatives, where it …