Prokinetics in the Management of Functional Gastrointestinal Disorders

Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract (S Rao, Section Editor)
First Online:
Part of the following topical collections:
  1. Topical Collection on Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract

Abstract

Purpose of review

The goal of this review is to review the current status of prokinetics and to place it in historical context. Impaired motility and thus propulsion have long been thought to play important roles in the pathogenesis of a number of gastrointestinal disorders including gastroesophageal reflux disease (GERD), gastroparesis, chronic idiopathic pseudo-obstruction, and constipation. Historically, disordered motility was also thought to contribute to a number of functional gastrointestinal disorders such as functional dyspepsia (FD) and irritable bowel syndrome (IBS).

Recent findings

As we learn more of the pathophysiology of FD, IBS, GERD, constipation, and gastroparesis, the limitations of a therapeutic strategy based on the stimulation of motility (i.e., the use of a prokinetic) have become apparent and the disappointments of the past explained. The development of prokinetic drugs has also been hampered by the non-selective nature of many of the agents studied to date which resulted in some unexpected side effects.

Summary

There is still an unmet need for an effective and safe prokinetic, but drug development in this area must be mindful of the challenges of the area and the need for selectivity for a given target receptor.

Keywords

Motility Prokinetic Acetylcholine Serotonin 5-Hydroxytryptamine Motilin Functional gastrointestinal disorders Irritable bowel syndrome Constipation Gastroparesis 
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Notes

Compliance with Ethical Standards

Conflict of Interest

The author has served as an advisor to, and has received research support from: Janssen, Movetis, Rhythm and Shire.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Lynda K and David M Underwood Center for Digestive DisordersHoustonUSA
  2. 2.Division of Gastroenterology and HepatologyThe Methodist HospitalHoustonUSA

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