Alternatives to prokinetics to move the pylorus and colon

作者:Pfab Florian*; Nowak Machen Martina; Napadow Vitaly; Fleckenstein Johannes
来源:Current Opinion in Clinical Nutrition and Metabolic Care, 2012, 15(2): 166-173.
DOI:10.1097/MCO.0b013e32834f3000

摘要

Purpose of review Gastrointestinal motility disorders (GMDs) are common in the ICU. When encountering these problems, one typically thinks of prokinetics. This review summarizes current evidence of treatments.
Recent findings
Prokinetics are not the first-line therapy for GMDs. In fact, the clinical implications of using prokinetic agents are rather controversial. Current evidence on alternative treatment modalities such as fluid and electrolyte management, laxatives, opioid antagonists, purgative enemas, acupuncture, physical therapies and probiotics is growing.
Summary
Current state of the art to treat GMDs is primarily focused at the elimination of underlying trigger factors. Fluid and electrolyte management as well as laxatives and peripherally acting m-opioid receptor antagonists are the recommended first-line therapies that can be complemented with prokinetics. Acupuncture as well as physical modalities, such as massage or warming of the abdomen, is promising with few side-effects and should be considered as well.

  • 出版日期2012-3