International Journal of Advances in Medicine | September 2021 | Vol 8 | Issue 9 Page 1442 International Journal of Advances in Medicine Rai RR et al. Int J Adv Med. 2021 Sep;8(9):1442-1449 http://www.ijmedicine.com pISSN 2349-3925 | eISSN 2349-3933 Review Article Prokinetics in the management of upper gastrointestinal motility disorders: an Indian expert opinion review Ramesh Roop Rai 1 , V. G. Mohan Prasad 2 * INTRODUCTION Functional gastrointestinal disorders (FGIDs) represent a group of disorders of gut-brain interaction. The 2016 ROME IV criteria classify FGIDs based on GI symptoms related to disturbance in motility, alteration in mucosal and immune function and visceral hypersensitivity, changes in gut microbiota, and alteration in central nervous system (CNS) processing. 1 Among these wide ranges of disorders, GI motility disturbances are known to affect a large population worldwide, leading to impaired health-related quality of life and adds to healthcare costs. 2 Population estimates indicate a point prevalence of FGIDs to be nearly 40%. Approximately two-third of individuals with FGIDs suffer from chronic and fluctuating symptoms. 3 Among FGIDs, GI motility disorders are common. Globally, 30%- 45% of all GI conditions are referred to as intestinal motility disorders. 4 Though classified as upper and lower GI motility disorders, symptom overlap makes the diagnosis challenging. Diagnosis can be ascertained with GI endoscopy as well as with GI functional tests. 2 The etiology of GI motility disorders is multifactorial and may be idiopathic in most patients. 4 Treatment approaches include dietary modifications, drugs, cognitive-behavioral therapies, and surgical management. 5 Pharmacological options to treat GI motility are varied. Prokinetics enhance motility and reduce visceral pain from gastric distention and can increase postprandial gastric accommodation. 5 Prokinetics act by different mechanisms modulating cholinergic, serotonergic, and dopaminergic pathways. 6 These are more effective in patients with FGIDs having delayed gastric emptying or postprandial distress. 7 However, prokinetics vary in their safety profiles. Given that FGIDs in India are quite common and because they are observed even in school children, it is essential that they are diagnosed in a timely manner and effectively managed. 8,9 Here, we reviewed the current therapeutic ABSTRACT Functional gastrointestinal disorders (FGIDs) are disorders of gut-brain interaction. Nearly 40% of individuals globally suffer from FGIDs and have chronic fluctuating symptoms. Of all GI conditions, 30-45% are referable to intestinal motility disorders. Prokinetics act by different mechanisms and are effective in FGIDs with delayed gastric emptying or postprandial distress. When choosing a prokinetic, safety is the primary concern, particularly with regard to the central nervous system and cardiovascular risk. Here, we review the efficacy and safety of prokinetics in functional GI motility disorders and provide expert opinions for the use of prokinetics to manage upper GI motility disorders in the Indian context. Keywords: Functional gastrointestinal disorders, Functional dyspepsia, Prokinetics, India 1 Rai Specialty Care Centre, Jaipur, Rajasthan, India 2 VGM Hospital, Coimbatore, Tamil Nadu, India Received: 30 June 2021 Revised: 09 August 2021 Accepted: 11 August 2021 *Correspondence: Dr. V. G. Mohan Prasad, E-mail: drvgma@hotmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/2349-3933.ijam20213253