What's in the pipeline for lower functional gastrointestinal disorders in the next 5 years?

Research output: Contribution to journalArticle

Abstract

The overall objectives of this review are to summarize actionable biomarkers for organic etiology of lower functional gastrointestinal disorders (FGIDs) that lead to individualized treatment for their FGIDs and to assess the pipeline for novel approaches to the management of constipation, diarrhea, and chronic abdominal pain in lower FGIDs. The new approaches to therapy include ion exchangers/transporters for functional constipation (sodium-glucose cotransporter 1, Na+/H+ exchanger 3, and solute carrier family 26 member 3 inhibitors), bile acid modulators for constipation such as ileal bile acid transporter inhibitors and fibroblast growth factor 19 analog for functional constipation, and bile acid sequestrants or farnesoid X receptor agonists for functional diarrhea. Treatment for chronic abdominal pain remains an unmet need in patients with lower FGIDs, and promising novel approaches include delayed-release linaclotide, nonclassical opioid visceral analgesics, and selective cannabinoid receptor agonists. The role of probiotics, fecal microbial transplantation, and possible future microbiome therapies is discussed.

Original languageEnglish (US)
Pages (from-to)G640-G650
JournalAmerican journal of physiology. Gastrointestinal and liver physiology
Volume317
Issue number5
DOIs
StatePublished - Nov 1 2019

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Gastrointestinal Diseases
Constipation
Bile Acids and Salts
Chronic Pain
Abdominal Pain
Diarrhea
Sodium-Glucose Transporter 1
Cannabinoid Receptor Agonists
Sodium-Hydrogen Antiporter
Fibroblast Growth Factors
Microbiota
Probiotics
Therapeutics
Opioid Analgesics
Biomarkers
Ions

Keywords

  • bile acid modulators
  • bile acid sequestrants
  • biomarkers
  • cannabinoid receptor agonists
  • individualized treatment
  • ion exchangers/transporters
  • linaclotide
  • opioid visceral analgesics

ASJC Scopus subject areas

  • Physiology
  • Hepatology
  • Gastroenterology
  • Physiology (medical)

Cite this

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title = "What's in the pipeline for lower functional gastrointestinal disorders in the next 5 years?",
abstract = "The overall objectives of this review are to summarize actionable biomarkers for organic etiology of lower functional gastrointestinal disorders (FGIDs) that lead to individualized treatment for their FGIDs and to assess the pipeline for novel approaches to the management of constipation, diarrhea, and chronic abdominal pain in lower FGIDs. The new approaches to therapy include ion exchangers/transporters for functional constipation (sodium-glucose cotransporter 1, Na+/H+ exchanger 3, and solute carrier family 26 member 3 inhibitors), bile acid modulators for constipation such as ileal bile acid transporter inhibitors and fibroblast growth factor 19 analog for functional constipation, and bile acid sequestrants or farnesoid X receptor agonists for functional diarrhea. Treatment for chronic abdominal pain remains an unmet need in patients with lower FGIDs, and promising novel approaches include delayed-release linaclotide, nonclassical opioid visceral analgesics, and selective cannabinoid receptor agonists. The role of probiotics, fecal microbial transplantation, and possible future microbiome therapies is discussed.",
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