Evaluation of Patients with Suspected Gastroparesis

Szarka, Lawrence A.; Camilleri, Michael

doi:10.1016/j.giec.2018.08.004

Cited by 13 publications

(32 citation statements)

References 62 publications

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“…Esophagogastroduodenoscopy (EGD) is commonly used as part of the GP evaluation as it can help rule out other causes of delayed emptying (eg, gastric outlet obstruction due to pyloric stenosis, neoplasia, or active ulcer disease) and allows visualization of fasting gastric contents, including bezoars, excess bilious fluid, and/or retained food. 48,49 It is recommended that adults who present with postprandial upper abdominal symptoms undergo an EGD prior to a GES. 22 Depending on EGD findings (retained food contents, no significant pathology in the presence of upper GI symptoms), motility, or other testing can be pursued afterward.…”

Section: Endoscopymentioning

confidence: 99%

Childhood gastroparesis is a unique entity in need of further investigation

Febo‐Rodriguez

Chumpitazi

Shulman

2019

Neurogastroenterology Motil

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Background Despite increasing knowledge regarding gastroparesis (GP) in adults, little is known regarding the incidence, prevalence, and natural history of childhood GP. Exacerbating the knowledge gap in pediatric GP is both the lack of normative data for gastric emptying scintigraphy in children and lack of GP‐specific pediatric reported outcome measures. Purpose The aim of this article was to review the available literature on pediatric GP and identify similarities and differences with studies in adults. We performed a comprehensive search in MEDLINE and Google Scholar from inception to April 2019 for articles published in English using the following combination of keywords: gastroparesis, pediatric gastroparesis, outcomes, metoclopramide, erythromycin, domperidone, cisapride, and gastric neurostimulator. The limited available pediatric data, often retrospective, suggest marked differences between adult and pediatric GP in several aspects including etiology, concomitant co‐morbidities (eg, psychiatric disorders), clinical symptom presentation, diagnostic evaluation, response to therapies, and clinical outcome. Further research in pediatric GP is needed and holds the promise to further elucidate the mechanisms of this disorder in children and lead to pediatric‐focused therapies.

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Section: Endoscopymentioning

confidence: 99%

Childhood gastroparesis is a unique entity in need of further investigation

Febo‐Rodriguez

Chumpitazi

Shulman

2019

Neurogastroenterology Motil

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“…Besides the presence of delayed GE, sensorimotor dysfunctions such as impaired gastric accommodation and hypersensitivity to gastric distention have been implicated in the symptom pattern and severity determination in both conditions (4,(10)(11)(12). Finally, prokinetic agents are advocated for the treatment of both conditions, although the evidence of their efficacy is modest (4,10,(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Gastric Emptying Rate and Simultaneously Assessed Symptoms in Functional Dyspepsia

Carbone

Buysscher

Houte

et al. 2022

Clinical Gastroenterology and Hepatology

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“…5 Furthermore, gastroparesis "severity" can be determined by the degree of gastric content retention at the 4-hour mark on GES (mild = 10%-15% retention, moderate = 16%-35% retention, severe = >35% retention). [6][7][8] While delayed gastric emptying is seen in approximately 4% of the population, delayed/impaired colonic "emptying" is one of the most commonly encountered complaints in gastroenterology. 9,10 Approximately 16% of all adults and 33% of those over the age of 60 suffer from constipation, which is defined by fewer than 3 bowel movements per week and/or difficulty passing stool.…”

Section: Introductionmentioning

confidence: 99%

Severe gastroparesis is associated with an increased incidence of slow‐transit constipation as measured by wireless motility capsule

Radetic

Kamal

Rouphael

et al. 2020

Neurogastroenterology Motil

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Background: Dysmotility in one region of the gastrointestinal tract has been found to predispose patients to developing motility disorders in other gastrointestinal segments. However, few studies have evaluated the relationship between gastroparesis and constipation.Methods: Retrospective review of 224 patients who completed 4-hour, solid-phase gastric emptying scintigraphy (GES), and wireless motility capsule (WMC) testing to evaluate for gastroparesis and slow-transit constipation, respectively. When available, anorectal manometry data were reviewed to evaluate for dyssynergic defecation.Patients were divided into two groups based on the results of the GES: 101 patients with normal gastric emptying and 123 patients with gastroparesis (stratified by severity). Differences in constipation rates were compared between the groups.Key results: Slow-transit constipation was more common in the gastroparesis group, but statistical significance was not reached (42.3% vs 34.7%, p = 0.304). Univariate logistical regression analysis found no association between slow-transit constipation and gastroparesis (OR 1.38, 95% CI 0.80-2.38, p = 0.245) nor dyssynergic defecation and gastroparesis (OR 0.88, 95% CI 0.29-2.70, p = 0.822). However, when stratifying gastroparesis based on severity, slow-transit constipation was found to be associated with severe gastroparesis (OR 2.45, 95% CI 1.20-5.00, p = 0.014). This association was strengthened with the exclusion of patients with diabetes mellitus (OR 3.5, 95% CI 1.39-8.83, p = 0.008) -a potential confounder. Conclusions & Inferences:Patients with severe gastroparesis (>35% gastric retention at the 4-hour mark on solid-phase GES) have an increased likelihood of having underlying slow-transit constipation. Dyssynergic defecation does not appear to be associated with gastroparesis (of any severity).

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Evaluation of Patients with Suspected Gastroparesis

Cited by 13 publications

References 62 publications

Childhood gastroparesis is a unique entity in need of further investigation

Childhood gastroparesis is a unique entity in need of further investigation

Relationship Between Gastric Emptying Rate and Simultaneously Assessed Symptoms in Functional Dyspepsia

Severe gastroparesis is associated with an increased incidence of slow‐transit constipation as measured by wireless motility capsule

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