DOI: http://dx.doi.org/10.18203/2349-3933.ijam20213253

Prokinetics in the management of upper gastrointestinal motility disorders: an Indian expert opinion review

Ramesh Roop Rai, V. G. Mohan Prasad

Abstract


Functional gastrointestinal disorders (FGIDs) are disorders of gut-brain interaction. Nearly 40% of individuals globally suffer from FGIDs and have chronic fluctuating symptoms. Of all GI conditions, 30-45% are referable to intestinal motility disorders. Prokinetics act by different mechanisms and are effective in FGIDs with delayed gastric emptying or postprandial distress. When choosing a prokinetic, safety is the primary concern, particularly with regard to the central nervous system and cardiovascular risk. Here, we review the efficacy and safety of prokinetics in functional GI motility disorders and provide expert opinions for the use of prokinetics to manage upper GI motility disorders in the Indian context. 


Keywords


Functional gastrointestinal disorders, Functional dyspepsia, Prokinetics, India

Full Text:

PDF

References


Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features, and Rome IV. Gastroenterol. 2016;150:1262-79.

Keller J, Bassotti G, Clarke J, Dinning P, Fox M, Grover M, et al. Advances in the diagnosis and classification of gastric and intestinal motility disorders. Nat Rev Gastroenterol Hepatol. 2018;15:291-308.

Black CJ, Drossman DA, Talley NJ, Ruddy J, Ford AC. Functional gastrointestinal disorders: advances in understanding and management. Lancet. 2020;396:1664-74.

Manabat ML, Piper MH. Intestinal Motility Disorders. 2020. https://emedicine.medscape.com/article/179937-overview#a6. Accessed on 29 December 2020.

Whitfield KL, Shulman RJ. Treatment options for functional gastrointestinal disorders: from empiric to complementary approaches. Pediatr Ann. 2009;38:288-90.

Quigley EM. Prokinetics in the management of functional gastrointestinal disorders. J Neurogastroenterol Motil. 2015;21:330-6.

Gudsoorkar V, Quigley EM. Choosing a prokinetic for your patient beyond metoclopramide. Am J Gastroenterol. 2020;115:5-8.

Ghoshal UC, Singh R. Frequency and risk factors of functional gastro-intestinal disorders in a rural Indian population. J Gastroenterol Hepatol. 2017;32:378-87.

Bhatia V, Deswal S, Seth S, Kapoor A, Sibal A, Gopalan S. Prevalence of functional gastrointestinal disorders among adolescents in Delhi based on Rome III criteria: A school-based survey. Indian J Gastroenterol. 2016;35:294-8.

Ouyang A, Locke GR 3rd. Overview of neurogastroenterology-gastrointestinal motility and functional GI disorders: classification, prevalence, and epidemiology. Gastroenterol Clin North Am. 2007;36:485-98.

Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation global study. Gastroenterol. 2020;160:99-114.

Mahadeva S, Goh KL. Epidemiology of functional dyspepsia: a global perspective. World J Gastroenterol. 2006;12:2661-6.

Ghoshal UC, Singh R. Functional dyspepsia: the Indian scenario. J Assoc Physicians India. 2012;60:S6-8.

Futagami S, Yamawaki H, Agawa S, Higuchi K, Ikeda G, Noda H, et al. New classification Rome IV functional dyspepsia and subtypes. Transl Gastroenterol Hepatol. 2018;3:70.

Aziz I, Palsson OS, Törnblom H, Sperber AD, Whitehead WE, Simrén M. Epidemiology, clinical characteristics, and associations for symptom-based Rome IV functional dyspepsia in adults in the USA, Canada, and the UK: a cross-sectional population-based study. Lancet Gastroenterol Hepatol. 2018;3:252-62.

Bhatia SJ, Makharia GK, Abraham P, Bhat N, Kumar A, Reddy DN, et al. Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology. Indian J Gastroenterol. 2019;38:411-40.

Chowdhury SD, George G, Ramakrishna K, Ramadass B, Pugazhendhi S, Mechenro J, et al. Prevalence and factors associated with gastroesophageal reflux disease in southern India: A community-based study. Indian J Gastroenterol. 2019;38:77-82.

Moayyedi PM, Lacy BE, Andrews CN, Enns RA, Howden CW, Vakil N. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017;112:988-1013.

Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L. American College of Gastroenterology. Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013;108:18-37.

Anudeep V, Vinod KV, Pandit N, Sharma VK, Dhanapathi H, Dutta TK, et al. Prevalence and predictors of delayed gastric emptying among Indian patients with long-standing type 2 diabetes mellitus. Indian J Gastroenterol. 2016;35:385-92.

Hasler WL. Gastroparesis--current concepts and considerations. Medscape J Med. 2008;10:16.

Yaylali O, Kirac S, Yilmaz M, Akin F, Yuksel D, Demirkan N, et al. Does hypothyroidism affect gastrointestinal motility?. Gastroenterol Res Pract. 2009;2009:529802.

Kashyap P, Farrugia G. Diabetic gastroparesis: what we have learned and had to unlearn in the past 5 years. Gut. 2010;59:1716-26.

Reddymasu SC, McCallum RW. Small intestinal bacterial overgrowth in gastroparesis: are there any predictors? J Clin Gastroenterol. 2010;44:e8-13.

Mounsey A, Barzin A, Rietz A. Functional dyspepsia: evaluation and management. Am Fam Physician. 2020;101:84-8.

Acosta A, Camilleri M. Prokinetics in gastroparesis. Gastroenterol Clin North Am. 2015;44:97-111.

Pittayanon R, Yuan Y, Bollegala NP, Khanna R, Lacy BE, Andrews CN, et al. Prokinetics for functional dyspepsia: a systematic review and meta-analysis of randomized control trials. Am J Gastroenterol. 2019;114:233-43.

Masuy I, Van Oudenhove L, Tack J. Review article: treatment options for functional dyspepsia. Aliment Pharmacol Ther. 2019;49:1134-72.

Sawant P, Das HS, Desai N, Kalokhe S, Patil S. Comparative evaluation of the efficacy and tolerability of itopride hydrochloride and domperidone in patients with non-ulcer dyspepsia. Journal Assoc Phys India. 2004;52:626-8.

Ranjan A, Chandra A, Kumar D. To study the comparative effects of Itopride and Levosulpiride orally used in patients suffering from non-ulcer dyspepsia. Int J Basic Clin Pharmacol. 2019;8:1915-8.

Vijayvargiya P, Camilleri M, Chedid V, Mandawat A, Erwin PJ, Murad MH. Effects of promotility agents on gastric emptying and symptoms: a systematic review and meta-analysis. Gastroenterol. 2019;156:1650-60.

Kim HI, Hong SJ, Han JP, Seo JY, Hwang KH, Maeng HJ, et al. Specific movement of esophagus during transient lower esophageal sphincter relaxation in gastroesophageal reflux disease. J Neurogastroenterol Motility. 2013;19:332.

Falk GW. Inhibition of transient lower esophageal sphincter relaxation in GERD: will lesogaberan advance the field?. Gastroenterol. 2010;139:377-9.

Forootan M, Zojaji H, Ehsani MJ, Darvishi M. Advances in the diagnosis of GERD using the esophageal pH monitoring, gastro-esophageal impedance-pH monitoring, and pitfalls. Open Access Maced J Med Sci. 2018;6:1934-40.

Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108:308-28.

Ren LH, Chen WX, Qian LJ, Li S, Gu M, Shi RH. Addition of prokinetics to PPI therapy in gastroesophageal reflux disease: a meta-analysis. World J Gastroenterol. 2014;20:2412-9.

Rai RR, Choubal CC, Agarwal M, Khaliq AM, Farishta FJ, Harwani YP, et al. A prospective multicentric postmarketing observational study to characterize the patient population with reduced gastrointestinal motility among Indian diabetic patients receiving itopride: The progress study. Int J App Basic Med Res. 2019;9:148-53.

Mansi C, Savarino V, Vigneri S, Perilli D, Melga P, Sciabà L, et al. Gastrokinetic effects of levosulpiride in dyspeptic patients with diabetic gastroparesis. Am J Gastroenterol. 1995;90:1989-93.

Joe J. Levosulpiride-induced neurological adverse effects: A prospective study from a tertiary care center. Ann Indian Acad Neurol. 2020;23:174-6.

Huang X, Lv B, Zhang S, Fan YH, Meng LN. Itopride therapy for functional dyspepsia: a meta-analysis. World J Gastroenterol. 2012;18:7371-7.

Talley NJ, Tack J, Ptak T, Gupta R, Giguere M. Itopride in functional dyspepsia: results of two phase III multicentre, randomised, double-blind, placebo-controlled trials. Gut. 2008;57:740-6.

Biswas M, Singh KM, Shetty YC, Koli PG, Ingawale S, Bhatia SJ. Prescription pattern & adverse drug reactions of prokinetics. Indian J Med Res. 2019;149:748-54.

Kaushal J, Gupta MC, Jindal P, Verma S. Self-medication patterns and drug use behavior in housewives belonging to the middle income group in a city in northern India. Indian J Community Med. 2012;37:16-9.

D'Souza RS, Hooten WM. Extrapyramidal symptoms. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls. 2020. https://www.ncbi.nlm.nih.gov/books/NBK534115/. Accessed oon

Tonini M, De Ponti F, Di Nucci A, Crema F. Cardiac adverse effects of gastrointestinal prokinetics. Aliment Pharmacol Ther 1999;13:1585-91.

Tack J, Camilleri M, Chang L, Chey WD, Galligan JJ, Lacy BE, et al. Systematic review: cardiovascular safety profile of 5-HT(4) agonists developed for gastrointestinal disorders. Aliment Pharmacol Ther. 2012;35:745-67.

Forbes N, Cooray M, Al-Dabbagh R, Yuan Y, Tse F, Liu LW, et al. Domperidone prescribing practices exposed patients to cardiac risk despite a "black box" warning: A Canadian tertiary care center study. Can J Gastroenterol Hepatol. 2016;2937678.

Ehrenpreis ED, Roginsky G, Alexoff A, Smith DG. Domperidone is commonly prescribed with QT-interacting drugs. J Clin Gastroenterol. 2017;51:56-62.

Bor S, Demir M, Ozdemir O, Yuksel K. A meta-analysis on the cardiac safety profile of domperidone compared to metoclopramide. United European Gastroenterol J. 2018;6:1331-46.

Gupta S, Kapoor V, Gupta BM, Verma U. Effect of itopride hydrochloride on QT interval in adult healthy volunteers. JK-Practitioner. 2005;12:207-10.