Abstract

Gastroparesis can be simply defined as delayed gastric emptying in the absence of mechanical obstruction. 1 Camilleri M. Parkman H.P. Shafi M.A. et al. Clinical guidelines: management of gastroparesis. Am J Gastroenterol. 2013; 108: 18-37 Crossref PubMed Scopus (594) Google Scholar Characteristic symptoms include nausea, vomiting, abdominal pain, early satiety, bloating, and weight loss. 1 Camilleri M. Parkman H.P. Shafi M.A. et al. Clinical guidelines: management of gastroparesis. Am J Gastroenterol. 2013; 108: 18-37 Crossref PubMed Scopus (594) Google Scholar , 2 Vijayvargiya P. Jameie-Oskooei S. Camilleri M. et al. Association between delayed gastric emptying and upper gastrointestinal symptoms: a systemic review and meta-analysis. Gut. 2019; 68: 804-813 Crossref PubMed Scopus (71) Google Scholar , 3 Moshiree B. Potter M. Talley N.J. Epidemiology and pathophysiology of gastroparesis. Gastrointest Endosc Clin N Am. 2019; 29: 1-14 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar More than 50 causes of gastroparesis have been identified; the most common are long-standing diabetes, prior gastric or esophageal surgery, medications (eg, opioids), or an underlying connective tissue disorder or vascular disorder. 3 Moshiree B. Potter M. Talley N.J. Epidemiology and pathophysiology of gastroparesis. Gastrointest Endosc Clin N Am. 2019; 29: 1-14 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar The largest group with gastroparesis, however, is that of patients labeled as having idiopathic gastroparesis. These are more likely to be women than men (4:1 ratio); a prior infectious or inflammatory insult is often the culprit. 1 Camilleri M. Parkman H.P. Shafi M.A. et al. Clinical guidelines: management of gastroparesis. Am J Gastroenterol. 2013; 108: 18-37 Crossref PubMed Scopus (594) Google Scholar ,3 Moshiree B. Potter M. Talley N.J. Epidemiology and pathophysiology of gastroparesis. Gastrointest Endosc Clin N Am. 2019; 29: 1-14 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar Although the definition of gastroparesis is simple, the pathophysiology is complicated. Often thought of as a motor disorder characterized by antral hypomotility (sometimes referred to as an impaired antral “pump”), the complex pathophysiology of gastroparesis includes impaired gastric accommodation, electrical dysrhythmias, antroduodenal dyscoordination, pyloric dysfunction, vagal nerve injury, and abnormal visceral sensation. The symptoms of gastroparesis are generally treated with dietary changes, antiemetic agents, and prokinetic agents. 4 Navas C.M. Patel N.K. Lacy B.E. Gastroparesis: medical and therapeutic advances. Dig Dis Sci. 2017; 62: 2231-2240 Crossref PubMed Scopus (27) Google Scholar Unfortunately, many patients have persistent symptoms despite these interventions, which has spurred researchers to investigate other therapeutic options, including pylorus-directed therapies such as botulinum toxin injection of the pylorus and gastric peroral endoscopic myotomy (G-POEM). 5 Pasricha T.S. Pasricha P.J. Botulinum toxin injection for treatment of gastroparesis. Gastrointest Endosc Clin N Am. 2019; 29: 97-106 Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar ,6 Abdelfatah M.M. Noll A. Kapil N. et al. Long-term outcome of gastric per-oral endoscopic pyloromyotomy in treatment of gastroparesis. Clin Gastroenterol Hepatol. 2021; 19: 816-824 Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar Pyloric dilation with the esophageal functional lumen imaging probe in gastroparesis improves gastric emptying, pyloric distensibility, and symptomsGastrointestinal EndoscopyVol. 94Issue 3PreviewThe role of decreased pyloric distensibility in gastroparesis as measured by the endolumenal functional luminal imaging probe (EndoFLIP) has been receiving increasing attention. In this study, we present clinical outcomes to pyloric dilation with the esophageal FLIP (EsoFLIP) in regard to gastric emptying, symptom evolution, and FLIP metrics. Full-Text PDF Open Access

Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call