ACHE and dyspepsia: The grade of ACHE expression in GI tissues correlates with eventual outcome and surgery requirement in patients with refractory constipation. More aggressive therapies are needed by patients with high-grade ACHE-positive distribution (Kobayashi et al., 2002). Acotiamide, a selective inhibitor of ACHE, was shown to stimulate GI motor activity in conscious dogs and approved for treatment of patients with functional dyspepsia (Nagahama et al., 2012; Nolan and Scott, 2013).