Jr. Malagelada et E. Distrutti, MANAGEMENT OF GASTROINTESTINAL MOTILITY DISORDERS - A PRACTICAL GUIDETO DRUG SELECTION AND APPROPRIATE ANCILLARY MEASURES, Drugs, 52(4), 1996, pp. 494-506
The focus of management of gastrointestinal motility disorders should
be to improve survival and quality of life. Some motor disorders are a
nnoying, but are compatible with virtually normal activity and carry n
o significant life risk. Conversely, other motor disorders are highly
incapacitating and may shorten life expectancy because of complication
s and nutritional impairment. Management is based first on establishin
g the correct diagnosis and prognosis; secondly, on adjusting therapy
to the severity of illness; and thirdly, on preventing significant com
plications. Simple recommendations on appropriate changes in lifestyle
and reassurance may suffice in mild cases. Pharmacological therapy an
d, exceptionally, surgical or nutritional measures may be required in
other patients. Generally, pharmacological agents should be directed t
owards correcting specific pathophysiological abnormalities, but this
is not always possible. Symptomatic relief may be achieved on an empir
ical basis. Long term treatment may often require the combination of d
ifferent therapeutic approaches either sequentially or simultaneously.