Potential of Pharmacological Correction of Gastrointestinal Motility Disorders

Aim: to  present key data on the role of gastrointestinal motility dysfunction in the pathogenesis of functional and organic diseases and the importance of acotiamide in the correction of these disorders and to introduce a resolution of the expert council of the Russian Gastroenterological Association and the Russian Society of Neurogastroenterology and Motility.

Key points. Gastrointestinal motility dysfunction represents a key pathogenetic factor that determines the development and clinical course of a broad range of diseases. Functional dyspepsia and gastroesophageal reflux disease are highly prevalent conditions, and motility impairments, such as impaired gastric accommodation and delayed gastric emptying, account for their frequent co-occurrence in the same patient. For the pharmacotherapy of these diseases, drug products with a prokinetic effect are of substantial importance. Acotiamide has a proven prokinetic effect, improves gastric accommodation and emptying, and reduces the severity of symptoms of postprandial distress syndrome and overlapping manifestations of gastroesophageal reflux disease. In a multicenter Russian study, a response to acotiamide therapy was noted in 74.1 % of patients with postprandial distress syndrome versus 51.9 % in the placebo group (p < 0.001). Dysmotility and its association with gastrointestinal symptoms in H. pylori-associated dyspepsia, reflux gastritis, and autoimmune gastritis, as well as therapeutic measures to correct these disorders and alleviate symptoms, require further research.

Conclusion. Further research into motility disorders of the gastrointestinal tract will help to elucidate the pathogenesis of a number of functional and organic gastroenterological diseases. The body of evidence from international and local studies confirms the clinical efficacy and safety of acotiamide. Its inclusion in national clinical guidelines justifies the use of the drug product in patients with functional dyspepsia and gastric motility disorders, including cases in combination with gastroesophageal reflux disease.

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