Opiates, the Pylorus, and Gastroparesis

Abstract

Ingestion of food results in gastric accommodation. This is followed by development of antral contractions, and, after food is triturated to a small particle size, pyloric relaxation and antropyloroduodenal coordination result in the emptying of food from the stomach. Failure of pyloric relaxation may impede gastric emptying. Therefore, there has been increased interest in treating gastroparesis with pyloric interventions such as injection of botulinum toxin or gastric peroral endoscopic myotomy (G-POEM) (Table 1).