Management of Gastroparesis: Beyond Basics

Tack, Jan; Vanormelingen, Christophe

doi:10.1007/s11938-014-0034-7

Cited by 13 publications

(6 citation statements)

References 50 publications

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“…In the late stage of diabetes, plasma ghrelin is decreased, which might be associated with anorexia, muscle atrophy, decreased body mass, or even gastric paralysis. Clinical studies have shown that patients with DGP have decreased serum ghrelin content [22]. The results in our study suggested that the content of serum ghrelin in the model group was lower than that in the blank group; our results are consistent with the previous literature.…”

Section: Study On the Influence Of Acupoints Selection On Ghrelin Andsupporting

confidence: 92%

Study on the influence of acupoints selection on ghrelin and GHSR expression in gastric fundus tissue of DGP rats

Yue¹,

Li²,

Liu³

et al. 2018

biomedicalresearch

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Objective: To explore the acupoint selection compatibility according to different departments and to study the influence on ghrelin and GHSR expression in the gastric fundus in rats with Diabetic Gastroparesis (DGP). Methods: Sixty male SPF SD rats were given adaptive feeding for one week and were randomly divided into a blank control group, a model group, the Zusanli and Zhongwan (ZZ) group, the Zusanli and Neiguan group (ZN), as well as the Zusanli and non-meridian acupoint (ZNA) group, with 12 rats in each group. Except for the blank group, the other 48 rats were used to establish a DGP model by using streptozotocin. Acupuncture therapy was performed from the end of the tenth week for an additional four weeks. Then the rats were sacrificed and the serum and gastric fundus tissues were collected. ELISA assay was used to detect the ghrelin content in the serum. The expression of ghrelin positive cells in the gastric fundus tissue was detected by immunohistochemistry. The expression of ghrelin and GHSR mRNA in the gastric fundus tissue was detected by real-time PCR. Results: Compared with the blank group, the food intake and the expression of ghrelin and GHSR mRNA in the gastric fundus tissue in the model group were significantly increased, while the small intestinal propulsion rate, the ghrelin content in the serum and the gray value of the gastric fundus were significantly decreased (P<0.05). Compared with the model group, the expression of ghrelin and GHSR mRNA in the gastric fundus tissue, the small intestinal propulsion rate, the ghrelin content in the serum and the gray value of the gastric fundus were significantly increased (P<0.05). Compared with the ZZ group, the food intake were significantly increased in the ZN and the ZNA groups (P<0.05), and the expression of ghrelin and GHSR mRNA in the gastric fundus tissue of rats were significantly increased (P<0.05) but the ghrelin content in the serum in ZN group was significantly decreased (P<0.05). Conclusions: The improvement of gastrointestinal motility in DGP by acupuncture therapy was associated with the ghrelin content in the serum and GHSR expression in the gastric fundus. The treatment effect of local acupoints compatibility was better than that of the distal acupoints compatibility, and the acupoint selection according to department was one of the main influencing factors of acupoints compatibility.

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Section: Study On the Influence Of Acupoints Selection On Ghrelin Andsupporting

confidence: 92%

Study on the influence of acupoints selection on ghrelin and GHSR expression in gastric fundus tissue of DGP rats

Yue¹,

Li²,

Liu³

et al. 2018

biomedicalresearch

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“…5,7,8 Treatment is medical therapy using prokinetics with metoclopramide. 9,10 If refractory to medical therapy, non-pharmacologic treatment, including botulinum toxin injection or gastric electrical stimulation, can be attempted; 10,11 however, this remains to be controversial. 10 Recently, G-POEM has been regarded as an emerging treatment.…”

Section: Diagnosis: Idiopathic Gastroparesismentioning

confidence: 99%

Idiopathic Gastroparesis Treated with Gastric Peroral Endoscopic Pyloromyotomy Using Endolumenal Functional Lumen Imaging Probe

Kang

Jung

2017

Korean J Gastroenterol

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Case: A 25-year-old man presented to the emergency clinic with epigastric pain. He was previously very healthy and served as a soldier. He developed abrupt epigastric pain and diarrhea three months prior to his initial visit. A doctor at the local clinic suspected infectious colitis and was prescribed an antibiotic at his first visit; however, there was no symptomatic improvements. He underwent colonoscopy, and intravenous hydrocortisone was prescribed under the impression of ulcerative colitis at the local clinic. This provided mild, transient symptomatic improvement and the patient was able to eat food. However, intermittent abdominal pain and nausea continued, and the patient lost 10 kg of weight during the first month. Later, the patient experienced abdominal pain, fever, and myalgia, and he was then referred to Asan Medical Center. His abdominal computed tomography (CT) scan showed a mild thickening of the gall bladder, but without stone. Under the impression of chronic cholecystitis, he underwent laparoscopic cholecystectomy. However, despite surgery, he still complained of chronic epigastric pain, nausea, and vomiting. He underwent upper endoscopy, which showed normal findings. Despite medical therapy with several prokinetics, including metoclopramide, he still experienced epigastric pain, nausea, and vomiting, resulting in more than 20 kg of weight loss during the last three months.Due to nausea and vomiting, he was unable to keep down any solid food, and required total parenteral nutrition. He was referred to the gastrointestinal (GI) clinic due to continuous abdominal pain, nausea, and vomiting without abnormal laboratory test results, including autoimmune antibodies and other inflammatory makers. To rule out gastric dysmotility disorder, gastric emptying scan (GES) was recommended.However, he was unable to eat the test meal for GES due to severe nausea. Instead of GES, he underwent barium upper GI series, which showed definite delayed barium passage at the pyloric ring (Fig. 1A, B). Electrogastrography revealed a representative image of gastric outlet obstruction (Fig. 2).

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“…However, none to date has reached a developmental stage compatible with becoming a prescription drug [16].…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Treatment of gastrointestinal autonomic neuropathy

Törnblom

2015

Diabetologia

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The symptoms caused by gastrointestinal autonomic neuropathy in diabetes mellitus is important to highlight since it affects a large proportion of people with diabetes, regardless of whether this is type 1 or type 2. Gastroparesis and general signs of bowel dysfunction, such as constipation, diarrhoea and abdominal pain are most often encountered and involve both pharmacological and non-pharmacological treatment options. This mini-review summarises a presentation given at the 'Diagnosis and treatment of autonomic diabetic neuropathy in the gut' symposium at the 2015 annual meeting of the EASD. It is accompanied by another mini-review on a topic from this symposium (by Azpiroz and Malagelada,

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Management of Gastroparesis: Beyond Basics

Cited by 13 publications

References 50 publications

Study on the influence of acupoints selection on ghrelin and GHSR expression in gastric fundus tissue of DGP rats

Study on the influence of acupoints selection on ghrelin and GHSR expression in gastric fundus tissue of DGP rats

Idiopathic Gastroparesis Treated with Gastric Peroral Endoscopic Pyloromyotomy Using Endolumenal Functional Lumen Imaging Probe

Treatment of gastrointestinal autonomic neuropathy

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