Pro-motility Agents

Many promotility agents, such as domperidone and  metoclopramide have very marginal effects on the symptoms of reflux. Furthermore they carry a significant risk of side-effects and their long-term use is not recommended because of the longterm risks of parkinsonian like symptoms. As such their use has significantly declined in recent years. However they are occasional useful in the short-term.

Azithromycin is an antibiotic which has been demonstrated to have positive effects on oeaophageal motility and is sometimes used to improve oesophageal function and swallowing, however it is unlicensed, is an antibiotic and therefore may have adverse consequences upon gastro-intestinal microbes. As such it’s use is generally reserved for patients with specific indications, particularly those with oesophageal dysmotility.