TY - JOUR
T1 - Clinical practice recommendations on the use of neuromodulators in gastroenterology
T2 - AMG (Asociación Mexicana de Gastroenterología) - AMNM (Asociación Mexicana de Neurogastroenterología y Motilidad) expert joint review
AU - Gómez-Escudero, O.
AU - Remes-Troche, J. M.
AU - Coss-Adame, E.
AU - García-Zermeño, K. R.
AU - Aquino-Matus, J.
AU - Jiménez-Pavón, J.
AU - Valdovinos-García, L. R.
AU - Vargas-Martínez, M. A.
AU - Amieva-Balmori, M.
AU - Arenas-Martínez, J. S.
AU - Félix-Téllez, F. A.
AU - Gómez-Castaños, P. C.
AU - Mejía-Rivas, M.
AU - Valdovinos-Díaz, M. A.
AU - Vázquez-Elizondo, G.
AU - Villar-Chávez, A. S.
AU - Gyawali, C. P.
N1 - Publisher Copyright:
© 2025 Asociación Mexicana de Gastroenterología
PY - 2025
Y1 - 2025
N2 - Disorders of gut-brain interaction (DGBI) are characterized by alterations in both central and peripheral gut-brain axis (GBA)-related stimuli, and include esophageal, gastroduodenal, intestinal and anorectal disorders. Despite the fact that several pathophysiologic mechanisms are involved, the mainstay of treatment is neuromodulators, a heterogeneous group of drugs that act on pathways related to central and peripheral pain processing. This expert review by both the AMG (Asociación Mexicana de Gastroenterología) and AMNM (Asociación Mexicana de Neurogastroenterología y Motilidad) summarizes a series of updated clinical recommendations based on an exhaustive review of the literature, regarding the use of neuromodulators for DGBI, and is grouped into six sections: pharmacologic principles, definition, classification, mechanism of action; indications and use in each DGBI subtype; up/downscaling strategies, combination therapy; adverse events; joint use along with psychiatry in the case of comorbidities; and non-pharmacologic neuromodulation. Furthermore, drug selection process tips and dose personalization according to individual groups and sensitivities are provided, and special cases with DGBI-psychiatric comorbidity, as well as overlap with another DGBI, are considered.
AB - Disorders of gut-brain interaction (DGBI) are characterized by alterations in both central and peripheral gut-brain axis (GBA)-related stimuli, and include esophageal, gastroduodenal, intestinal and anorectal disorders. Despite the fact that several pathophysiologic mechanisms are involved, the mainstay of treatment is neuromodulators, a heterogeneous group of drugs that act on pathways related to central and peripheral pain processing. This expert review by both the AMG (Asociación Mexicana de Gastroenterología) and AMNM (Asociación Mexicana de Neurogastroenterología y Motilidad) summarizes a series of updated clinical recommendations based on an exhaustive review of the literature, regarding the use of neuromodulators for DGBI, and is grouped into six sections: pharmacologic principles, definition, classification, mechanism of action; indications and use in each DGBI subtype; up/downscaling strategies, combination therapy; adverse events; joint use along with psychiatry in the case of comorbidities; and non-pharmacologic neuromodulation. Furthermore, drug selection process tips and dose personalization according to individual groups and sensitivities are provided, and special cases with DGBI-psychiatric comorbidity, as well as overlap with another DGBI, are considered.
KW - Functional dyspepsia
KW - Gut-brain axis
KW - Gut-brain disorders
KW - Irritable bowel syndrome
KW - Neuromodulators
UR - http://www.scopus.com/inward/record.url?scp=86000452822&partnerID=8YFLogxK
U2 - 10.1016/j.rgmx.2024.12.001
DO - 10.1016/j.rgmx.2024.12.001
M3 - Article
AN - SCOPUS:86000452822
SN - 0375-0906
JO - Revista de gastroenterología de México
JF - Revista de gastroenterología de México
ER -