Effects of prokinetics on the digestive tract.

Abstract

Background: Functional gastrointestinal disorders account for at least a third of visits to gastroenterology clinics. Despite pathophysiological complexity, an impaired gut motility may be frequently present in these disorders. Introduction: Prokinetics are a class of drugs that promote gastrointestinal motility, acelerate transit and potentially improve digestive symptoms. Several prokinetic agents with a great variety of mechanisms of action are available.The purpose of this paper is to update our current knowledge about efficacy and safety of prokinetics. Methods: A literature search for efficacy and safety of prokinetics was carried out using the online databases of Pubmed, Medline and Cochrane. Results : On the basis of different receptorial action, prokinetics mainly comprise dopamine antagonists, 5HT4 agonists, motilin agonists, ghrelin agonists and cholinergic agonists. Prokinetics have the potential to improve motility function in all segments of digestive tract, from the esophagus to colon. In particular, drug international agencies approved antidopaminergic metoclopramide for the treatment of gastroparesis and serotoninergic prucalopride for chronic constipation not responsive to traditional laxatyves. Arrythmias by QT prolongation and galactorrea by prolactin stimulation are the more frequent side effects related to prokinetics use. Conclusions: Old and new prokinetics are effective in ameliorating digestive motility disorders and related symptoms and consequently are widely prescribed. Special attention should be paid to potential adverse events of these agents.