MANAGEMENT OF UPPER GASTROINTESTINAL MOTILITY DISORDERS: IDENTIFYING GAPS AND ROLE OF PROKINETICS IN FUNCTIONAL DYSPEPSIA (FD) AND DIABETIC GASTROPARESIS (DGP)

The management of Functional Dyspepsia (FD) and Diabetic Gastroparesis (DGP) remains challenging due to the complexity of these disorders, which involve upper gastrointestinal motility disturbances with overlapping symptoms. A panel of Indian gastroenterology experts convened to discuss the diagnosis and treatment of FD and DGP, with a focus on the role of prokinetics. The experts emphasised the importance of thorough diagnostic evaluations to rule out other conditions before diagnosing FD, such as upper endoscopy for patients with alarming symptoms or refractory cases. In DGP, scintigraphy remains the gold standard for conrming delayed gastric emptying. Both FD and DGP often require individualized treatment approaches based on symptom severity and patient proles. Prokinetics emerged as a cornerstone therapy for both FD and DGP. Among these, itopride was highlighted as the prokinetic of choice due to its dual action of enhancing gastric motility and alleviating symptoms with minimal side effects. The experts recommended itopride over alternatives like domperidone and levosulpiride for its favourable safety prole and effectiveness, particularly in treating symptoms of early satiety and postprandial fullness. The panel also discussed the benets of combining prokinetics with acid-suppressive therapies, especially in FD patients with overlapping symptoms, and underscored the importance of glycaemic control and nutritional management in DGP