Ment of persistence to proton pump inhibitors or non-acid reflux episodes in individuals with gastroesophageal reflux disease is difficult. Prucalopride, a selective high affinity serotonin (5-HT4) receptor agonist, could offer a probable new therapeutic alterative. Case presentations: We report 4 chronically constipated female gastroesophageal reflux disease-patients with reflux symptoms and an elevated quantity of reflux episodes in combined esophageal pH and multichannel impedance monitoring treated with prucalopride (2mg every day). Symptoms had been persistent to proton pump i nhibitors and ranitidine. Gastroesophageal reflux was detected by pH or multichannel impedance (MII) monitoring. Numbers of all reflux episodes too as non-acid reflux episodes had been decreased in all of our sufferers. The objective findings were concordant with subjective reports of symptom relief. There were no significant adverse events in any patient through therapy with prucalopride. Conclusion: Administration of prucalopride showed promising final results within the therapy of persisting or weakly and/or non-acid reflux episodes in our case series in 4 constipated patients. Thus, prucalopride may be regarded as a feasible therapeutic choice within the remedy of typical proton pump inhibitor-persistent reflux in the chronically constipated patient. Nonetheless, further prospective trials are required to prove our findings. Search phrases: GERD, Gastroesophageal reflux, Non-acid reflux, PPI-persistent reflux, Prucalopride, pH or multichannel impedance (MII) monitoringIntroduction Gastroesophageal reflux illness (GERD) can be a relevant disorder in western countries with rising frequency and incidence [1]. Most sufferers with acid reflux episodes do adequately respond to proton pump inhibitor (PPI) therapy [2].tert-Butyl 4-hydroxybutanoate site Far more difficult is treatment of “PPIpersistent” or weakly and/or non-acid reflux episodes, which may possibly also bring about relevant reflux symptoms [3]. In persistent symptoms to typical PPI therapy, high-dose PPI therapy or baclofen, a GABA B agonist, are reported to lower weakly and/or non-acid gastroesophageal reflux episodes in single cases [4].Methyl 3,5-dioxohexanoate Formula Whereas double doses of PPIs are an suitable therapy with considerable reduction of liquid and/or mixed reflux events [5],* Correspondence: valentin.PMID:23812309 [email protected] Klinikum rechts der Isar der Technischen Universit M chen, II. Medizinische Klinik und Poliklinik, Ismaninger Strasse 22, 81675 M chen, Germanyavailable data related to baclofen therapy are inconclusive and symptom responder prices are poor [6]. Within the previous, cisapride, a procinetic non-selective serotonin (5-HT4) receptor agonist, was applied with superior amelioration of reflux symptoms [7]. Therapeutic effects may possibly be explained by a reduce in transient reduce esophageal sphincter relaxation, enhanced decrease esophageal motor activity, and enhanced gastric or duodenal emptying [8-11]. Nevertheless, because of serious cardiac side-effects (QTtime prolongation), cisapride was removed from the market place inside the year 2000 [12]. Prucalopride, a brand new selective high affinity serotonin (5-HT4) receptor agonist, was introduced on the German market in 2010. It is actually approved within the therapy of chronic constipation in women and stimulates colonic movement [13]. Furthermore, feasible effects on upper intestinal motility comparable to cisapride are conceivable. So far, no reports around the effect of prucalopride in GERD patients are obtainable.?2014 Nennstiel et al.; licensee BioMed Central Ltd. That is an Op.