Chapter 32 - Studies from the NIH Gastroparesis Clinical Research Consortium: Towards improving our understanding and treatment of gastroparesis

Abstract

The NIH Gastroparesis Clinical Research Consortium (GpCRC) was initiated to improve the understanding of the pathogenesis and natural history of gastroparesis and to advance the diagnosis and therapy of patients affected with this troubling condition. Over the last 13 years of study, the GpCRC has learned a tremendous amount about gastroparesis as well as conditions with symptoms of gastroparesis but with normal gastric emptying. The main symptoms of gastroparesis - nausea, vomiting, early satiety, abdominal pain; each of these can impair quality of life. Gastroparesis symptoms can also occur in patients with normal gastric emptying, a condition termed Chronic Unexplained Nausea and Vomiting (CUNV). Gastric emptying tests document the delay in gastric emptying. Scintigraphy can reveal more on pathophysiology in gastroparesis than just global gastric emptying, assessing different regions of the stomach – the fundus, antrum, and pylorus. Wireless motility capsule can also assess for extragastric transit abnormalities – small bowel transit and colon transit. These regional motility abnormalities may relate to symptoms. Treatments may target underlying pathophysiology, such as delayed gastric emptying and impaired accommodation, as well as specific symptoms such as nausea and vomiting. This chapter summaries some of the findings of the Gastroparesis Clinical Research Consortium as published in peer reviewed manuscripts.