Management of gastrointestinal motility disorders. A practical guide to drug selection and appropriate ancillary measures.
The focus of management of gastrointestinal motility disorders should be to improve survival and quality of life. Some motor disorders are annoying, but are compatible with virtually normal activity and carry no significant life risk. Conversely, other motor disorders are highly incapacitating and may shorten life expectancy because of complications and nutritional impairment. Management is based first on establishing the correct diagnosis and prognosis; secondly, on adjusting therapy to the severity of illness; and thirdly, on preventing significant complications. Simple recommendations on appropriate changes in lifestyle and reassurance may suffice in mild cases. Pharmacological therapy and, exceptionally, surgical or nutritional measures may be required in other patients. Generally, pharmacological agents should be directed towards correcting specific pathophysiological abnormalities, but this is not always possible. Symptomatic relief may be achieved on an empirical basis. Long term treatment may often require the combination of different therapeutic approaches either sequentially or simultaneously.
Digestive System Research Unit, Hospital General Universitari Vall d'Hebron, Autonomous University of Barcelona, Spain.
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JR
Malagelada
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Distrutti
D000322:Adrenergic Agonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002118:Calcium / Q000037:antagonists & inhibitors; D002637:Chest Pain / Q000188:drug therapy / Q000209:etiology; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004724:Endoscopy; D015154:Esophageal Motility Disorders / Q000188:drug therapy* / Q000209:etiology; D005769:Gastrointestinal Motility / Q000187:drug effects*; D018589:Gastroparesis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D054328:Proton Pump Inhibitors
D000322:Adrenergic Agonists; D000890:Anti-Infective Agents; D018727:Muscarinic Antagonists; D054328:Proton Pump Inhibitors; D002118:Calcium