Pathophysiology, Aetiology and Treatment of Gastroparesis

Sullivan, Ashley F.; Temperley, L; Ruban, Aruchuna

doi:10.1007/s10620-020-06287-2

Cited by 32 publications

(53 citation statements)

References 165 publications

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“…Gastric emptying is a physiological process that allows the transit of digested food to the duodenum[ 2 ]. It is a mechanical process and is regulated by a complex neurohormonal control[ 11 , 12 ]. In neuronal control, the parasympathetic participates through the vagus nerve which afferences fibers arrive from the enteric system to the nucleus of the solitary tract, and then pass to the vagus dorsal motor nucleus in the spinal cord, from where it exits to the myenteric plexus (see Figure 2 ).…”

Section: Physiologymentioning

confidence: 99%

“…The gastric fundus serves as a reservoir of content (initially, it relaxes due to nitrogen stimuli)[ 2 , 15 ] and then acts as a pressure pump. In the gastric body-antrum, the food content is mixed at a speed of 3 peristaltic waves per minute[ 12 , 13 , 16 ], the pylorus acts as a gate that filters only the 1-2 mm digested food and returns the largest foods[ 17 ]. In gastric emptying, 2 phases are recognized; the digestive (whose purpose is to transport the chyme to the duodenum) and the interdigestive (which several trains of peristaltic waves have the purpose of complete the gastric emptying of the indigestible particles); the hormones that accelerate emptying participate in this latter process[ 11 ].…”

Section: Physiologymentioning

confidence: 99%

“…Manometry results indicated that patients with insulin treatment were associated with greater swallowing weakness, without significant association with glycosylated hemoglobin levels[ 25 ]. Acute hyperglycemic episodes are related to lower esophageal motility and greater dysphagia[ 12 ]. Besides, the presence of autonomic and peripheral neuropathy and retinopathy is associated with a higher frequency of erosive esophagitis compared to patients without neuropathy[ 26 ].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…It has been reported that 50% of patients with idiopathic gastroparesis are overweight or obese, and the symptoms differ with body mass index. Obese patients have fewer symptoms of loss of appetite or inability to finish a meal but have higher rates of gastroesophageal reflux[ 12 ].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

See 3 more Smart Citations

Diabetic gastroenteropathy: An underdiagnosed complication

Concepción-Zavaleta¹,

Yovera²,

Marreros³

et al. 2021

WJD

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This article is an extensive review that provides an update on the pathophysiology, symptoms, diagnosis, and treatment of diabetic gastroenteropathy. There is no reported prevalence, but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%, and type 2 patients, 1%. Also, in the group of type 1 diabetes, it has been observed that women are more likely to present this condition (5.8% vs 3.5%). Many factors are associate with its development ( e.g. , hyperglycemia, vagal dysfunction, loss of expression of neural nitric oxide synthase in the myenteric plexus, alterations in the Cajal interstitial cell network, and oxidative stress). Gastrointestinal discomfort could be perceived 70% higher in diabetic patients, describing that 25% of diabetic patients experience gastrointestinal symptoms. Diabetic enteropathy could affect any portion of the gastrointestinal tract, but esophageal alterations were described in more than 60% of diabetic patients, also 60% of them present constipation, and 20%, diarrhea. Gastric emptying scintigraphy is useful to evaluate gastroparesis, therefore, gastric retention of more than 60% at 2 h has a sensitivity of 100% and specificity of 20% for diagnosis; however, other studies such as breath tests, with a sensitivity of 89% and a specificity of 80%, or the endoscopic capsule contribute to the diagnosis. There is no cure; however, management must be multidisciplinary, focused on slowing the progression of diabetic gastroenteropathy, reducing symptoms, and restoring function; that includes nutritional recommendation, maintain glucose levels kept below 180 mg/dL, use of prokinetics, anti-emetics; nowadays, it has been special interest in surgical treatment, such as pyloroplasty, also gastric electrical stimulation appears to be another alternative.

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Section: Physiologymentioning

confidence: 99%

Section: Physiologymentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

See 2 more Smart Citations

Diabetic gastroenteropathy: An underdiagnosed complication

Concepción-Zavaleta¹,

Yovera²,

Marreros³

et al. 2021

WJD

View full text Add to dashboard Cite

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“…The Rome IV classification system for functional gastrointestinal disorders (FGIDs) defines functional nausea in children and adolescents as bothersome nausea (a) occurring at least twice per week for at least two months as the primary symptom experienced, (b) not typically accompanied by vomiting, (c) not usually associated with meals, (d) not better explained by another diagnosis [ 3 ]. Functional nausea is a clinical diagnosis that is made after relevant evaluation for other possible underlying organic causes, such as inflammatory bowel disease [ 4 ], gastroparesis [ 5 ], eosinophilic esophagitis [ 6 ], celiac disease [ 7 ], and gastritis [ 8 ], has been reassuring.…”

Section: Introductionmentioning

confidence: 99%

“My Body Hates Me”: A Qualitative Analysis of the Experience of Functional Nausea in Adolescent Girls and Their Mothers

et al. 2020

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Nausea is a somatic sensation typically associated with the need to vomit in order to remove a toxin from the body. When nausea occurs in the absence of a specific structural cause or toxin, it is classified as a functional gastrointestinal disorder (FGID). Functional nausea was newly recognized in 2016 as a FGID in children and little is known about its prevalence, course or patient experiences. Nausea co-occurring with functional abdominal pain in childhood has been associated with long-term risk for anxiety and ongoing somatic symptoms into young adulthood. However, few studies have focused uniquely on the experience and impact of nausea on youth. The present study aimed to qualitatively understand the experiences of adolescent girls with functional nausea and their parents. Five mother–daughter dyads were recruited from a specialized pediatric gastroenterology clinic focused on nausea and completed semi-structured interviews. Interviews were transcribed and coded using interpretive phenomenological analysis (IPA). Four main themes emerged: nausea interference, body frustration, misunderstanding of symptoms, and maternal helplessness and guilt. These themes were similar to prior studies on the experiences of youth with chronic pain but also indicated unique challenges due to nausea, such as significant food restriction and subsequent weight loss.

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Gastric Gastrointestinal Stromal Tumors with Gastroparesis After Surgery

Tu,

Zhang,

2024

Clinical Management of Gastrointestinal Stromal Tumor

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Pathophysiology, Aetiology and Treatment of Gastroparesis

Cited by 32 publications

References 165 publications

Diabetic gastroenteropathy: An underdiagnosed complication

Diabetic gastroenteropathy: An underdiagnosed complication

“My Body Hates Me”: A Qualitative Analysis of the Experience of Functional Nausea in Adolescent Girls and Their Mothers

Gastric Gastrointestinal Stromal Tumors with Gastroparesis After Surgery

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