Motilin effects on the proximal stomach in patients  with functional dyspepsia and healthy volunteers

Kamerling, Ingrid M C; Haarst, Aernout D. van; Burggraaf, Jacobus; Schoemaker, Rik C.; Biemond, I.; Heinzerling, Hartmut; Jones, Rose Marie; Cohen, Adam F.; Masclee, Ad

doi:10.1152/ajpgi.00456.2002

Cited by 25 publications

(26 citation statements)

References 25 publications

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“…Efficacy in a subset of those patients with lower body mass index and hemoglobin A1C suggests a role in nondiabetics with upper gastrointestinal symptoms [176] . Motilin receptor agonists are known to decrease gastric accommodation and compliance [177,178] and are susceptible to tachyphylaxis, both factors that may contribute to limited efficacy in FD.…”

Section: Targeting Electromechanical Dysfunctionmentioning

confidence: 99%

Visceral hypersensitivity and electromechanical dysfunction as therapeutic targets in pediatric functional dyspepsia

Rosen

Cocjin

Schurman

et al. 2014

WJGPT

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Functional gastrointestinal disorders (FGID) are common clinical syndromes diagnosed in the absence of biochemical, structural, or metabolic abnormalities. They account for significant morbidity and health care expenditures and are identifiable across variable age, geography, and culture. Etiology of abdominal pain associated FGIDs, including functional dyspepsia (FD), remains incompletely understood, but growing evidence implicates the importance of visceral hypersensitivity and electromechanical dysfunction. This manuscript explores data supporting the role of visceral hypersensitivity and electromechanical dysfunction in FD, with focus on pediatric data when available, and provides a summary of potential therapeutic targets. Visceral sensitivity and intestinal electromechanical function both are demonstrated to be altered in some FD patients and are potential targets for treatment. Limited studies in pediatric FD are available, but available evidence supports adult data that targeting visceral hypersensitivity and electromechanical dysfunction is warranted, particularly in the context of the biopsychosocial model. Future studies in pediatrics are needed to determine optimal therapy and appropriate patient application.Rosen JM, Cocjin JT, Schurman JV, Colombo JM, Friesen CA. Visceral hypersensitivity and electromechanical dysfunction as therapeutic targets in pediatric functional dyspepsia. World

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Section: Targeting Electromechanical Dysfunctionmentioning

confidence: 99%

Visceral hypersensitivity and electromechanical dysfunction as therapeutic targets in pediatric functional dyspepsia

Rosen

Cocjin

Schurman

et al. 2014

WJGPT

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“…Furthermore, studies assessing the effect of erythromycin on gastric tone reported that administration of motilin or of erythromycin reduced meal-induced relaxation [100][101][102] , thereby enhancing sensitivity to gastric distention [103] . This adverse effect of erythromycin on gastric accommodation to a meal may contribute to its overall poor symptomatic response in patients with FD.…”

Section: Erythromycinmentioning

confidence: 99%

Promotility Medications – Now and in the Future

Karamanolis

Tack²

2006

Dig Dis

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Gastrointestinal promotility drugs stimulate smooth muscle contractions to enhance gastric emptying and small and large bowel transit. Currently available drug classes with prokinetic properties include antidopaminergic agents, serotonergic agents, and motilin-receptor agonists. Due to moderate prokinetic effects, poor symptomatic responses and the presence of adverse effects, there is a clear need for new classes of prokinetics. Several newer prokinetic drugs and drug classes are currently under evaluation. Selecting candidate agents and designing the appropriate therapeutic trials is hampered by the lack of insight in the pathophysiology of motility-related symptoms. As gastrointestinal motor disorders are chronic, relapsing, and remitting disorders, it seems desirable that studies with candidate prokinetic drugs establish a long-term efficacy and not only short-term effects on gastrointestinal functions.

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“…Bei Patienten mit funktioneller Dyspepsie ist die Wirkung von Erythromycin und anderen selektiven Motilinrezeptoragonisten auf die Symptomenintensität unzureichend. So zeigte sich nicht nur eine fehlende Überlegenheit gegenüber Plazebo, sondern eine signifikante Verschlechterung der epigastrischen Beschwerden [21,36]. Dies zeigt, dass die Beschleunigung der Magenentleerung nicht ausreicht, dyspeptische Symptome zu bessern.…”

Section: Erythromycinunclassified

Funktionelle Dyspepsie – eine Verlegenheitsdiagnose?

2006

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Dyspepsia comprises a broad spectrum of predominantly upper abdominal symptoms, such as pain, indigestion, nausea, early satiety and bloating. While these symptoms are highly prevalent, in less than 50% of patients presenting with dyspepsia, structural lesions or biochemical abnormalities are found that explain the symptoms when routine clinical tests are used. In patients without structural lesions the diagnosis of functional dyspepsia is justified. Exclusion of life-threatening disorders as the cause of symptoms and reassurance of the patient as well as proper explanation of the diagnosis and its underlying disease mechanisms (i.e. symptoms are due to a sensitive gut) is crucial and can be considered as an essential element of treatment. Since there is a remarkable comorbidity of anxiety and depression, psychosomatic interventions might be necessary in selected patients. Based on controlled clinical trials few drugs, such as proton pump inhibitors, prokinetics, tricyclic antidepressants, simethicone and selected herbal preparations have been found to be effective for treatment of functional dyspepsia. Effects of H. pylori eradication, even though strongly advocated, are most likely due to undiagnosed peptic ulcer disease in a very small group of patients. While there is currently no therapy that cures functional dyspepsia, the therapeutic target is to control symptoms.

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Motilin effects on the proximal stomach in patients with functional dyspepsia and healthy volunteers

Cited by 25 publications

References 25 publications

Visceral hypersensitivity and electromechanical dysfunction as therapeutic targets in pediatric functional dyspepsia

Visceral hypersensitivity and electromechanical dysfunction as therapeutic targets in pediatric functional dyspepsia

Promotility Medications – Now and in the Future

Funktionelle Dyspepsie – eine Verlegenheitsdiagnose?

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