Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 22: What Is The Role Of Prokinetic Agents In The Treatment Of Gerd, And How Do I Know Which One To Use? (continued)

Conceptually, a “promotility or motility-altering agent” is still held up as the ideal agent to treat GERD. Addressing the underlying pathophysiologic defects of the lower esophageal sphincter, augmenting esophageal clearance, and increasing gastric emptying would indeed constitute the ideal therapy. Unfortunately the effects of prokinetic agents on lower esophageal sphincter pressure and esophageal clearance are transient at best, and accelerating gastric emptying has not been documented in any study I am aware of to improve symptoms in GERD patients. Since the withdrawal of…