What is the role of prokinetic agents in dysphagia management?

• A. To cure GERD in all patients.
• B. To reduce LES tone universally.
• C. To enhance esophageal or gastric motility in select motility disorders; evidence varies and use is case-dependent.
• D. To directly repair mucosal injuries.

Answer: (C)

Prokinetic agents are used when swallowing difficulty is tied to slowed or poorly coordinated movement of the esophagus or stomach. They work by boosting esophageal peristalsis and/or speeding gastric emptying, which helps propel the swallowed bolus more effectively and reduces stasis that can worsen dysphagia. Because motility disorders vary widely from person to person, the benefit of prokinetics is not universal and must be considered on a case-by-case basis; the evidence supporting their use differs depending on the specific motility issue and patient response. They are not a cure for GERD in all patients, they do not universally decrease LES tone, and they do not directly repair mucosal injuries. Their role is to enhance propulsion when the primary problem is impaired motility.