Gut Liver.  2017 Sep;11(5):579-589. 10.5009/gnl16336.

Gastroparesis Updates on Pathogenesis and Management

Affiliations
  • 1Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville, Louisville, KY, USA. thomas.abell@louisville.edu

Abstract

Gastroparesis (Gp) is a chronic disease that presents with clinical symptoms of early satiety, bloating, nausea, vomiting, and abdominal pain. Along with these symptoms, an objective finding of delayed gastric emptying, along with a documented absence of gastric outlet obstruction, are required for diagnosis. This article focuses on updates in the pathogenesis and management of Gp. Recent studies on full thickness biopsies of Gp patients have shed light on the complex interactions of the central, autonomic, and enteric nervous systems, which all play key roles in maintaining normal gut motility. The management of Gp has evolved beyond prokinetics and antiemetics with the use of gastric electrical stimulators (GES). In addition, this review aims to introduce the concept of gastroparesis-like syndrome (GLS). GLS helps groups of patients who have the cardinal symptoms of Gp but have a normal or rapid emptying test. Recent tests have shown that patients with Gp and GLS have similar pathophysiology, benefit greatly from GES placement, and likely should be treated in a similar manner.

Keyword

Nausea; Vomiting; Gastroparesis; Enteric nervous system; Gastric emptying

MeSH Terms

Abdominal Pain
Antiemetics
Biopsy
Chronic Disease
Diagnosis
Enteric Nervous System
Gastric Emptying
Gastric Outlet Obstruction
Gastroparesis*
Humans
Nausea
Vomiting
Antiemetics
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