gastrointestinal agents


Summary: Drugs used for their effects on the gastrointestinal system, as to control gastric acidity, regulate gastrointestinal motility and water flow, and improve digestion.

Top Publications

  1. Schmulson M, Chang L. Review article: the treatment of functional abdominal bloating and distension. Aliment Pharmacol Ther. 2011;33:1071-86 pubmed publisher
    ..Abdominal bloating and distension are common symptoms in patients with functional gastrointestinal disorders (FGIDs), however, relatively little is known about their treatment...
  2. Graff G, Maguiness K, McNamara J, Morton R, Boyd D, Beckmann K, et al. Efficacy and tolerability of a new formulation of pancrelipase delayed-release capsules in children aged 7 to 11 years with exocrine pancreatic insufficiency and cystic fibrosis: a multicenter, randomized, double-blind, placebo-controlled, two-period. Clin Ther. 2010;32:89-103 pubmed publisher
    ..Pancrelipase delayed-release capsules appeared to be well tolerated. identifier: NCT00690820. (Clin Ther. ..
  3. Omata F, Deshpande G, Tokuda Y, Takahashi O, Ohde S, Carr Locke D, et al. Meta-analysis: somatostatin or its long-acting analogue, octreotide, for prophylaxis against post-ERCP pancreatitis. J Gastroenterol. 2010;45:885-95 pubmed publisher
    ..Somatostatin and high-dose octreotide may prevent post-ERCP pancreatitis. The preventive efficacy of somatostatin is more prominent in cases of PD injection, or BS, or high-dose administration over 12 h, or bolus injection. ..
  4. Rao A, Wong B, Camilleri M, Odunsi Shiyanbade S, McKinzie S, Ryks M, et al. Chenodeoxycholate in females with irritable bowel syndrome-constipation: a pharmacodynamic and pharmacogenetic analysis. Gastroenterology. 2010;139:1549-58, 1558.e1 pubmed publisher
    ..The rate of bile acid synthesis influences colonic transit. Genetic variation in negative feedback inhibition of bile acid synthesis may affect CDC-mediated acceleration of colonic transit. ..
  5. Altraif I, Handoo F, Aljumah A, Alalwan A, Dafalla M, Saeed A, et al. Effect of erythromycin before endoscopy in patients presenting with variceal bleeding: a prospective, randomized, double-blind, placebo-controlled trial. Gastrointest Endosc. 2011;73:245-50 pubmed publisher
    ..Blood in the stomach and esophagus in patients with variceal bleeding often obscures the endoscopic view and makes endoscopic intervention difficult to perform. Erythromycin, a motilin agonist, induces gastric emptying...
  6. Bai Y, Guo J, Li Z. Meta-analysis: erythromycin before endoscopy for acute upper gastrointestinal bleeding. Aliment Pharmacol Ther. 2011;34:166-71 pubmed publisher
    ..Studies evaluating the effect of erythromycin on patients with acute upper gastrointestinal bleeding (UGIB) had been reported, but the results were inconclusive...
  7. Rippel S, Acra S, Correa H, Vaezi M, Di Lorenzo C, Walker L. Pediatric patients with dyspepsia have chronic symptoms, anxiety, and lower quality of life as adolescents and adults. Gastroenterology. 2012;142:754-61 pubmed publisher
  8. Gubergrits N, Malecka Panas E, Lehman G, Vasileva G, Shen Y, Sander Struckmeier S, et al. A 6-month, open-label clinical trial of pancrelipase delayed-release capsules (Creon) in patients with exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery. Aliment Pharmacol Ther. 2011;33:1152-61 pubmed publisher
    ..Pancrelipase was well tolerated over 6 months and resulted in statistically significant weight gain and reduced stool frequency in patients with EPI due to CP or PS previously managed with standard PERT. ..
  9. Littlewood J, Connett G, Sander Struckmeier S, Henniges F. A 2-year post-authorization safety study of high-strength pancreatic enzyme replacement therapy (pancreatin 40,000) in cystic fibrosis. Expert Opin Drug Saf. 2011;10:197-203 pubmed publisher
    ..1 kg in patients < 18 years old). No safety concerns were identified with pancreatin 40,000 therapy for up to 2 years. Daily lipase doses were not increased when switching to pancreatin 40,000. ..

More Information


  1. Pateron D, Vicaut E, Debuc E, Sahraoui K, Carbonell N, Bobbia X, et al. Erythromycin infusion or gastric lavage for upper gastrointestinal bleeding: a multicenter randomized controlled trial. Ann Emerg Med. 2011;57:582-9 pubmed publisher
    ..We determine whether in acute upper gastrointestinal bleeding the frequency of satisfactory stomach visualization was different after intravenous erythromycin, a nasogastric tube with gastric lavage, or both...
  2. Thorat V, Reddy N, Bhatia S, Bapaye A, Rajkumar J, Kini D, et al. Randomised clinical trial: the efficacy and safety of pancreatin enteric-coated minimicrospheres (Creon 40000 MMS) in patients with pancreatic exocrine insufficiency due to chronic pancreatitis--a double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2012;36:426-36 pubmed publisher
  3. Zhou M, Chen B, Sun H, Jin Y, Yang F, Zhang X, et al. Continuous regional arterial infusion with fluorouracil and octreotide attenuates severe acute pancreatitis in a canine model. PLoS ONE. 2012;7:e37347 pubmed publisher
    ..05). The findings in the present study demonstrate an attenuation of SAP in a canine model following CRAI administration with 5-Fu or Oct, alone or in combination. ..
  4. Bryant A, Busby R, Bartolini W, Cordero E, Hannig G, Kessler M, et al. Linaclotide is a potent and selective guanylate cyclase C agonist that elicits pharmacological effects locally in the gastrointestinal tract. Life Sci. 2010;86:760-5 pubmed publisher
    ..This pharmacological profile suggests that orally administered linaclotide may be capable of improving the abdominal symptoms and bowel habits of patients suffering from IBS-C and chronic constipation. ..
  5. Sjöberg M, Walch A, Meshkat M, Gustavsson A, Järnerot G, Vogelsang H, et al. Infliximab or cyclosporine as rescue therapy in hospitalized patients with steroid-refractory ulcerative colitis: a retrospective observational study. Inflamm Bowel Dis. 2012;18:212-8 pubmed publisher
    ..Colectomy frequencies were significantly lower after rescue therapy with CsA than with a single infusion of IFX both at 3 and 12 months' follow-up. The superiority of CsA was seen principally during the first 15 days. ..
  6. Sharma P, Sharma B, Sarin S. Critical flicker frequency for diagnosis and assessment of recovery from minimal hepatic encephalopathy in patients with cirrhosis. Hepatobiliary Pancreat Dis Int. 2010;9:27-32 pubmed
    ..CFF is a simple, relatively reliable, and accurate test without any dependence on age or literacy in the diagnosis and assessment of recovery of patients with MHE. ..
  7. Odunsi Shiyanbade S, Camilleri M, McKinzie S, Burton D, Carlson P, Busciglio I, et al. Effects of chenodeoxycholate and a bile acid sequestrant, colesevelam, on intestinal transit and bowel function. Clin Gastroenterol Hepatol. 2010;8:159-65 pubmed publisher
    ..12). No effects on mucosal permeability or safety were identified. Sodium chenodeoxycholate in health and colesevelam in IBS-D patients have opposite effects on colonic transit and fecal parameters. ..
  8. Arai M, Matsumura T, Tsuchiya N, Sadakane C, Inami R, Suzuki T, et al. Rikkunshito improves the symptoms in patients with functional dyspepsia, accompanied by an increase in the level of plasma ghrelin. Hepatogastroenterology. 2012;59:62-6 pubmed publisher
    ..The aim of this study was to investigate the effect of rikkunshito on upper gastrointestinal symptoms and the levels of acylated ghrelin (AG) in patients with FD...
  9. Zhou H, Gao J, Wu W, Liu L, Wei L, Zou D, et al. Octreotide ameliorates intestinal dysmotility by interstitial cells of Cajal protection in a rat acute necrotizing pancreatitis model. Pancreas. 2011;40:1226-33 pubmed publisher
    ..The pathogenesis of the ileus in ANP may be related to the sustained deficiencies in ICCs. Octreotide may ameliorate the severity of ileus by minimizing the injury of ICCs. ..
  10. Lembo A, Kurtz C, MacDougall J, Lavins B, Currie M, Fitch D, et al. Efficacy of linaclotide for patients with chronic constipation. Gastroenterology. 2010;138:886-95.e1 pubmed publisher
    ..Linaclotide therapy was associated with few adverse events and produced rapid and sustained improvement of bowel habits, abdominal symptoms, global relief, and quality of life in patients with chronic constipation. ..
  11. Vazquez Roque M, Camilleri M. Linaclotide, a synthetic guanylate cyclase C agonist, for the treatment of functional gastrointestinal disorders associated with constipation. Expert Rev Gastroenterol Hepatol. 2011;5:301-10 pubmed publisher
    ..From animal studies to human pharmacodynamic Phase Ib trials, and a comprehensive program of Phase IIb and III trials in health and disease, linaclotide demonstrates long-term efficacy and safety in CC and IBS-C. ..
  12. Chey W, Camilleri M, Chang L, Rikner L, Graffner H. A randomized placebo-controlled phase IIb trial of a3309, a bile acid transporter inhibitor, for chronic idiopathic constipation. Am J Gastroenterol. 2011;106:1803-12 pubmed publisher
    ..We conducted an 8-week, multicenter, randomized, double-blind, placebo-controlled, parallel group, phase IIb study, which evaluated A3309 in patients with chronic idiopathic constipation (CIC)...
  13. Szary N, Gupta R, Choudhary A, Matteson M, Arif M, Hammad H, et al. Erythromycin prior to endoscopy in acute upper gastrointestinal bleeding: a meta-analysis. Scand J Gastroenterol. 2011;46:920-4 pubmed publisher
    ..Therefore, a meta-analysis was performed comparing the efficacy of erythromycin infusion prior to endoscopy in acute UGIB...
  14. Schey R, Rao S. Lubiprostone for the treatment of adults with constipation and irritable bowel syndrome. Dig Dis Sci. 2011;56:1619-25 pubmed publisher
    ..Thus far, lubiprostone offers a novel approach to our therapeutic armamentarium, however, there is a need for more drugs with different mechanisms of action, in order to treat constipation that is often multifunctional. ..
  15. Barkun A, Bardou M, Martel M, Gralnek I, Sung J. Prokinetics in acute upper GI bleeding: a meta-analysis. Gastrointest Endosc. 2010;72:1138-45 pubmed publisher
    ..Recent data suggest that administration of prokinetics before gastroscopy may be useful in patients with acute upper GI bleeding (UGIB). Published studies are limited in the number of subjects evaluated, and the conclusions are disparate...
  16. Whitcomb D, Lehman G, Vasileva G, Malecka Panas E, Gubergrits N, Shen Y, et al. Pancrelipase delayed-release capsules (CREON) for exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery: A double-blind randomized trial. Am J Gastroenterol. 2010;105:2276-86 pubmed publisher
    ..Pancrelipase delayed-release 12,000-lipase unit capsules were effective in treating fat and nitrogen maldigestion with a TEAE rate similar to that of placebo in patients with EPI due to CP or PS. ..
  17. Monnikes H. Quality of life in patients with irritable bowel syndrome. J Clin Gastroenterol. 2011;45 Suppl:S98-101 pubmed publisher
    ..Evidence also indicates that HRQoL in patients with IBS is affected by sex and psychological conditions. Careful consideration of these factors may help to individualize a therapeutic strategy to optimize long-term outcomes. ..
  18. Prantera C, Lochs H, Grimaldi M, Danese S, Scribano M, Gionchetti P. Rifaximin-extended intestinal release induces remission in patients with moderately active Crohn's disease. Gastroenterology. 2012;142:473-481.e4 pubmed publisher
    ..Administration of 800 mg rifaximin-EIR twice daily for 12 weeks induced remission with few adverse events in patients with moderately active CD. ..
  19. Wang C, Zhao X, You S. Efficacy of the prophylactic use of octreotide for the prevention of complications after pancreatic resection: An updated systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2017;96:e7500 pubmed publisher
    ..However, no obvious differences were noted regarding mortality. In view of the clinical heterogeneity and varying definitions of PF, whether these conclusions are broadly applicable should be further determined in future studies. ..
  20. Troncone E, Monteleone G. The safety of non-biological treatments in Ulcerative Colitis. Expert Opin Drug Saf. 2017;16:779-789 pubmed publisher
    ..Preliminary data indicate that such compounds have better overall safety and tolerability than corticosteroids and immunosuppressive drugs. ..
  21. Satoh H, Amagase K, Takeuchi K. Mucosal protective agents prevent exacerbation of NSAID-induced small intestinal lesions caused by antisecretory drugs in rats. J Pharmacol Exp Ther. 2014;348:227-35 pubmed publisher
  22. Ananthakrishnan A, Oxford E, Nguyen D, Sauk J, Yajnik V, Xavier R. Genetic risk factors for Clostridium difficile infection in ulcerative colitis. Aliment Pharmacol Ther. 2013;38:522-30 pubmed publisher
    ..Compared to 11% for a clinical model, the genetic loci explained 28% of the variance in CDI risk and had a greater AUROC. Host genetics may influence susceptibility to Clostridium difficile infection in patients with ulcerative colitis. ..
  23. Miller M, Burjonrappa S. A review of enteral strategies in infant short bowel syndrome: evidence-based or NICU culture?. J Pediatr Surg. 2013;48:1099-112 pubmed publisher
    ..Prospective trials should be encouraged to bridge the evidence gap between research and clinical practice to promote further progress in the field. ..
  24. Marzano A, Menicanti C, Crosti C, Trevisan V. Neutrophilic dermatoses and inflammatory bowel diseases. G Ital Dermatol Venereol. 2013;148:185-96 pubmed
  25. Kuboki S, Shimizu H, Yoshidome H, Ohtsuka M, Kato A, Yoshitomi H, et al. Chylous ascites after hepatopancreatobiliary surgery. Br J Surg. 2013;100:522-7 pubmed publisher
    ..Chylous ascites is a rare complication following HPB surgery. It is more common after pancreatic resection. Treatment with octreotide combined with total parenteral nutrition is recommended. ..
  26. Luceri C, Femia A, Fazi M, Di Martino C, Zolfanelli F, Dolara P, et al. Effect of butyrate enemas on gene expression profiles and endoscopic/histopathological scores of diverted colorectal mucosa: A randomized trial. Dig Liver Dis. 2016;48:27-33 pubmed publisher
    ..Butyrate enemas may prevent the atrophy of the diverted colon/rectum, thus improving the recovery of tissue integrity. ..
  27. Madani S, Cortes O, Thomas R. Cyproheptadine Use in Children With Functional Gastrointestinal Disorders. J Pediatr Gastroenterol Nutr. 2016;62:409-13 pubmed publisher
    ..5-fold (P?=?0.01). Cyproheptadine effectively improves symptoms of Rome III-defined FGIDs and has a good safety profile when used for these indications. ..
  28. Naganuma M, Sakuraba A, Hibi T. Ulcerative colitis: prevention of relapse. Expert Rev Gastroenterol Hepatol. 2013;7:341-51 pubmed publisher
    ..Recent studies have confirmed that biologics are effective for inducing clinical and endoscopic remission of UC, and thus they may improve long-term prognosis of UC. ..
  29. Althumairi A, Lazarev M, Gearhart S. Inflammatory bowel disease associated neoplasia: A surgeon's perspective. World J Gastroenterol. 2016;22:961-73 pubmed publisher
    ..A multidisciplinary team including the surgeon, gastroenterologist, pathologist, and the patient who has a clear understanding of the nature of their disease is needed to optimize outcomes. ..
  30. Harnett D, Chandra Sekhar H, Hamilton S. Drug-induced lupus erythematosus presenting with cardiac tamponade: a case report and literature review. Can J Cardiol. 2014;30:247.e11-2 pubmed publisher
    ..In conclusion, DILE should be considered in the differential diagnosis in cases of pericarditis with cardiac tamponade without a clear cause. ..
  31. Rojas Feria M, Castro M, Suarez E, Ampuero J, Romero Gomez M. Hepatobiliary manifestations in inflammatory bowel disease: the gut, the drugs and the liver. World J Gastroenterol. 2013;19:7327-40 pubmed publisher
    ..Diagnosis and management of these disorders usually involve hepatologists and gastroenterologists due to its complexity. ..
  32. Chatzaki E, Anton P, Million M, Lambropoulou M, Constantinidis T, Kolios G, et al. Corticotropin-releasing factor receptor subtype 2 in human colonic mucosa: down-regulation in ulcerative colitis. World J Gastroenterol. 2013;19:1416-23 pubmed publisher
    ..The down-regulation of the CRF2 receptor in the distal/sigmoid biopsies of UC patients is indicative of change in CRF2 signalling associated with the process of inflammation. ..
  33. Cao Y, Yan W, Lu L, Tao Y, Lu W, Chen Y, et al. Parenteral nutrition combined with rice soup can be a safe and effective intervention for congenital chylous ascites. Asia Pac J Clin Nutr. 2016;25:631-5 pubmed publisher
  34. Sultan S, Coles B, Dahm P. Alvimopan for recovery of bowel function after radical cystectomy. Cochrane Database Syst Rev. 2017;5:CD012111 pubmed publisher
    ..The need for reinsertion of nasogastric tubes is reduced. We found no evidence for the impact on rates of parenteral nutrition within 30 postoperative days. ..
  35. Huang W, Jiang S, Jia L, You L, Huang Y, Gong Y, et al. Effect of amitriptyline on gastrointestinal function and brain-gut peptides: a double-blind trial. World J Gastroenterol. 2013;19:4214-20 pubmed publisher
    ..Low-dose AMT could slow OCTT, make the stomach less sensitive and increase the plasma levels of ghrelin and NPY. Thus, we recommend the use of low-dose AMT for functional gastrointestinal disorders. ..
  36. Oliveira S, Monteiro I. Diagnosis and management of inflammatory bowel disease in children. BMJ. 2017;357:j2083 pubmed publisher
    ..This review summarizes the evidence on the pathophysiology, diagnosis, and approaches to management of children and adolescents with IBD. ..
  37. Flick A, Ding H, Leverett C, Kyne R, Liu K, Fink S, et al. Synthetic Approaches to the New Drugs Approved During 2015. J Med Chem. 2017;60:6480-6515 pubmed publisher
    ..This annual review describes the most likely process-scale synthetic approaches to 29 new chemical entities (NCEs) that were approved for the first time in 2015. ..
  38. Zhao Z, Liu H, Sun X, Guo T, Shen L, Tao Y, et al. Levistilide A inhibits angiogenesis in liver fibrosis via vascular endothelial growth factor signaling pathway. Exp Biol Med (Maywood). 2017;242:974-985 pubmed publisher
    ..These findings suggest that levistilide A may be a great potential drug for treating liver fibrosis through antiangiogenesis, and this effect will be verified in other fibrotic animal model studies or by clinical trials...
  39. Chang S, Hanauer S. Optimizing pharmacologic management of inflammatory bowel disease. Expert Rev Clin Pharmacol. 2017;10:595-607 pubmed publisher
    ..Future IBD treatment should focus on personalized therapy plans based on genetic determinants, targeted mechanisms of action, and pharmacologic optimization. ..
  40. Hellström A, Farkkila M, Kolho K. Infliximab-induced skin manifestations in patients with inflammatory bowel disease. Scand J Gastroenterol. 2016;51:563-71 pubmed publisher
    ..Anti-TNF-? therapy is frequently associated with newly onset skin reactions, most commonly in patients with Crohn's disease. Non-infectious skin manifestations can be treated topically and do not require cessation of anti-TNF-? therapy. ..
  41. Moayyedi P, Lacy B, Andrews C, Enns R, Howden C, Vakil N. ACG and CAG Clinical Guideline: Management of Dyspepsia. Am J Gastroenterol. 2017;112:988-1013 pubmed publisher
    ..We recommend PPI, TCA and prokinetic therapy (in that order) in those that fail therapy or are H. pylori negative. We do not recommend routine upper gastrointestinal (GI) motility testing but it may be useful in selected patients. ..
  42. Friedman A, Sparrow M, Gibson P. The role of thiopurine metabolites in inflammatory bowel disease and rheumatological disorders. Int J Rheum Dis. 2014;17:132-41 pubmed
    ..There is a paucity of data on thiopurine metabolites in rheumatological diseases and further research is required. ..
  43. Waghray A, Waghray N, Kanna S, Mullen K. Optimal treatment of hepatic encephalopathy. Minerva Gastroenterol Dietol. 2014;60:55-70 pubmed
    ..Lactulose and rifaximin are two commonly used treatments for the management of HE. This article will review the optimal management of hepatic encephalopathy. ..
  44. Yu J, Liu S, Fang X, Zhang J, Gao J, Xiao Y, et al. Gastrointestinal symptoms and associated factors in Chinese patients with functional dyspepsia. World J Gastroenterol. 2013;19:5357-64 pubmed publisher
    ..Female sex, anxiety, and sleep disorder, weight loss, consulting a physician and prokinetic use during 1-year follow-up were associated with outcome of FD. ..
  45. Baek S, Kim S, Kwak J, Kim J. Incidence and risk factors of chylous ascites after colorectal cancer surgery. Am J Surg. 2013;206:555-9 pubmed publisher
    ..In addition, the incidence was also dependent on the operator. Conservative treatment was effective in most patients. ..
  46. Matsuoka K, Kanai T. Mechanism and therapeutic strategy of secondary failure to anti-tumor necrosis factor-? monoclonal antibody treatment for Crohn's disease. Digestion. 2013;88:17-9 pubmed publisher
    ..It is also important to make the appropriate drug selection and to clarify the optimal timing of dose intensification for achieving long-term maintenance of remission, including discussion of the first priority use of adalimumab. ..
  47. Camilleri M. Current and future pharmacological treatments for diarrhea-predominant irritable bowel syndrome. Expert Opin Pharmacother. 2013;14:1151-60 pubmed publisher
    ..While symptomatic treatment of diarrhea is effective, there is a need for new treatments for the IBS-D complex. Greater understanding of the mechanisms in IBS-D has led to promising approaches to develop more efficacious therapies. ..
  48. Groth C, Banzon E. Octreotide for the treatment of hypoglycemia after insulin glargine overdose. J Emerg Med. 2013;45:194-8 pubmed publisher
    ..Prolonged hypoglycemia often occurs after large overdoses of insulin glargine due to a depot effect at the site of injection. Octreotide is a potential adjunctive treatment to dextrose in patients with a functioning pancreas. ..
  49. Palmieri B, Merighi A, Corbascio D, Rottigni V, Fistetto G, Esposito A. Fixed combination of hyaluronic acid and chondroitin-sulphate oral formulation in a randomized double blind, placebo controlled study for the treatment of symptoms in patients with non-erosive gastroesophageal reflux. Eur Rev Med Pharmacol Sci. 2013;17:3272-8 pubmed
    ..01 between group comparison). A fixed combination of HA+CS has demonstrated to be effective in gastroesophageal reflux control, with a rapid onset of action. ..
  50. Fashner J, Gitu A. Common gastrointestinal symptoms: irritable bowel syndrome. FP Essent. 2013;413:16-23 pubmed
    ..For long-term therapy, tricyclic antidepressants or selective serotonin reuptake inhibitors have good efficacy. Peppermint oil and probiotics also may provide benefit. ..
  51. Tada Y, Ishihara S, Ito T, Matsui K, Sonoyama H, Oka A, et al. Successful use of maintenance infliximab for nephropathy in a patient with secondary amyloidosis complicating Crohn's disease. Intern Med. 2013;52:1899-902 pubmed
  52. Chacko K, Sigal S. Update on management of patients with overt hepatic encephalopathy. Hosp Pract (1995). 2013;41:48-59 pubmed publisher
    ..Recent advances in treatment and preventative therapies may reduce the personal, societal, and economic impact of this disorder. ..
  53. Chen X, Zhai X, Shi J, Liu W, Tao H, Sun X, et al. Lactulose mediates suppression of dextran sodium sulfate-induced colon inflammation by increasing hydrogen production. Dig Dis Sci. 2013;58:1560-8 pubmed publisher
    ..Lactulose can prevent the development of DSS-induced colitis and alleviate oxidative stress in the colon, as measured by MDA and MPO, probably by increasing endogenous H2 production. ..