Peak amplitude in the distal esophagus occurred at 15 min. The authors conclude that bethanechol produces a substantial increase in the contraction pressure of esophageal smooth muscle, leading to improved bolus transit in patients with severe IEM. The results suggest a role for cholinergic nerves in the control of esophageal peristalsis. Reprints and Permissions. Bethanechol is an effective treatment for ineffective esophageal motility.
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Sorry, a shareable link is not currently available for this article. Prokinetics help strengthen the lower esophageal sphincter LES and cause the contents of the stomach to empty faster. This allows less time for acid reflux to occur. Today, prokinetics are typically used with other gastroesophageal reflux disease GERD or heartburn medications, such as proton pump inhibitors PPIs or H2 receptor blockers. Unlike these other acid reflux medications, which are generally safe, prokinetics may have serious, or even dangerous, side effects.
Bethanechol Urecholine is a medication that stimulates the bladder and helps you pass urine if you are having trouble emptying your bladder. It helps strengthen the LES, and makes the stomach empty faster.
It also helps prevent nausea and vomiting. It is available in tablet form. However, its usefulness may be outweighed by frequent side effects. Its side effects can include:. Cisapride Propulsid acts on serotonin receptors in the stomach. It was primarily used to improve muscle tone in the LES. However, because of its side effects, such as irregular heartbeat, it has been removed from the market in several countries, including the United States.
Cisapride is still often used in veterinary medicine. Metoclopramide Reglan is a prokinetic agent that has been used to treat GERD by improving muscle action in the gastrointestinal tract. Side effects may include an increased risk of neurological conditions such as tardive dyskinesia, which causes involuntary repetitive movements. These side effects have been known to occur in people who remain on the drug for more than three months.
Antacids, however, can have side effects, including diarrhea and constipation. These medications are available in both over-the-counter and prescription strengths. H2 blockers provide short-term or on-demand relief and are effective for many people with GERD symptoms.
They can also help heal the esophagus, although not as well as proton pump inhibitors PPIs. PPIs include omeprazole Prilosec, Zegerid , lansoprazole Prevacid , pantoprazole Protonix , rabeprazole Aciphex , and esomeprazole Nexium , which are available by prescription. Omeprazole and lansoprazole also come in over-the-counter strength. However, studies show people who take PPIs long term or in high doses are more likely to have hip, wrist, and spinal fractures.
People should take these medications on an empty stomach in order for stomach acid to activate them. Prokinetics, which include bethanechol Urecholine and metoclopramide Reglan , help make the stomach empty faster. However, both bethanechol and metoclopramide have side effects that often limit their use, including nausea, diarrhea, tiredness, depression, anxiety, and problems with physical movement. Prokinetics can interact with other medications, so people taking prokinetic agents should tell their health care provider about all medications they are taking.
Antibiotics, including one called erythromycin, have been shown to improve gastric emptying. Erythromycin has fewer side effects than bethanechol and metoclopramide; however, like all antibiotics, it can cause diarrhea. All of these medications work in different ways, so combinations of medications may help control symptoms.
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