[Prokinetics in reflux disease. Action mechanisms and clinical effects]

Gastro-oesophageal reflux disease is a primary motility disorder of the upper gastro-intestinal tract, with varying degrees of disturbed lower oesophageal sphincter function, disturbed peristalsis of the oesophageal body and delayed gastric emptying. Traditional treatment has focused on "detoxifying" the refluxate by suppressing gastric acid secretion. With the advent of cisapride (Prepulsid), prokinetic drugs offer a possibility of influencing the underlying motility disturbances without causing the serious side effects of earlier prokinetic drugs. It seems to be well documented that cisapride is useful in both the short-term and the long-term treatment of grade 1 reflux oesophagitis, and also in more severe cases as part of combination regimens involving acid suppressive drugs.