Prucalopride for the treatment of ileus

Postoperative ileus (POI) is an impairment of coordinated gastrointestinal (GI) motility that develops as a consequence of abdominal surgery and is a major factor contributing to patient morbidity and prolonged hospitalisation. Despite the availability of various options its treatment is still under debate. This review will focus on effect of Prucalopride (5-HT₄ receptor agonist) on postoperative ileus based on the existing literature. Areas covered: A literature search of MEDLINE, EMBASE and COCHRANE Library was performed concerning topics related to the treatment of ileus with prucalopride. The search strategy also included articles relating to other treatments of ileus for comparison with prucalopride. Expert opinion: Postoperative ileus remains difficult to treat and most strategies encompass preventative measures through enhanced recovery after surgery and laparoscopic approaches. The role of pharmacological intervention is developing with some drugs licensed for use. The evidence for prucalopride remains unclear although there is randomised controlled trial (RCT) evidence available. Given the potential for reduction in patient morbidity and length of stay the role of prucalopride in POI should be further investigated with multi-centre RCTs to establish which group of patients will gain the most from this exciting potential treatment.