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c 2017 The Korean Society of Neurogastroenterology and Motility J Neurogastroenterol Motil, Vol. 23 No. 2 April, 2017 www.jnmjournal.org TO THE EDITOR: With great interest we read the paper by Lee et al “effect of DA-9701, a novel prokinetic agent, on post-operative ileus in rats.” The main finding seems to be that DA-9701 can ameliorate post-operative ileus (POI) by reducing delayed gastrointestinal transit (GIT) and improving ghrelin levels after surgery in a rat model of POI. Both the Pharbitidis Seed and Corydalis Tuber have been extensively used for centuries as medical herbs respectively in the control of gastrointestinal motility and visceral pain in China. The Chinese Pharmacopoeia says that Pharbitidis, with strong purgative action, resembles Jalapin in chemical properties in aspects of secretion of bile and intestinal juice, which can stimulate and enhance intestinal peristalsis. Corydalis possesses soothing, narcotic, and tranquilizing properties; it is commonly used to alleviate abdominal pains and mild depression, mild mental disorders, emotional disturbances, severe nerve damage, and limb tremors. With the new technological application, both pharbitidis seeds and corydalis extractions were synthesized as one medication named as Motilitone (DA-9701) by Dong-A Pharmaceutical in Korea. It has been a new medication for functional dyspepsia since December 2011 in Korea. As stated by Lee et al, post-operative ileus is a common complication of abdominal surgery, and therefore such a POI rat model is used in the study. The authors provide evaluations about the effect of DA-9701 on bowel motility in a variety of postoperative conditions in rats. Certain parameters indicate that DA9701 significantly accelerates gastric emptying, increases fecal pellet weights, and elevates ghrelin serum levels. Therefore, it is logically implicated that DA-9701 can prevent or control POI. There are serval concerns raised in the paper. First, the paper is titled as “Effect of DA-9701, a novel prokinetic agent, on postoperative ileus in rats.” What the novelty of the study is when compared to the literature about DA-9701 is this study regarding DA9701 on POI. Many literatures on DA-9701 have already been acknowledged with its prokinetic effect in gut motility. Whilst, this study is mimic a post-operation ileus (by using minor surgery) to compare the changes of GIT, fecal weight, and ghrelin that are affected by DA-9701. In the procedures as shown in Figure 1, the acclimatization period for rats was 7 days, and DA-9701 was gavaged once respectively before and after operation, without vehicle or agent as a control. It is unclear why the 7 days acclimatization is necessary without time course scaling comparison; also, it is hard to believe that any effect or change, without a control, resulted from DA-9701 instead of mechanical delivery. A rational explanation needs to be addressed by the authors. To look up GIT parameters and stool weight as shown in Figure 2, the effect from DA-9701 could be categorized as no surgery/no medication (NSNM) versus no surgery/medication

The Evidence of DA-9701 on Bowel Motility