Foods Provoking and Alleviating Symptoms in Gastroparesis: Patient Experiences

Wytiaz, Victoria; Homko, Carol J.; Duffy, Frank; Schey, Ron; Parkman, Henry P.

doi:10.1007/s10620-015-3651-7

Cited by 52 publications

(28 citation statements)

References 9 publications

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“…A study of 45 patients identified that foods provoking symptoms, such as orange juice, fried chicken, cabbage, oranges, sausage, pizza, peppers, onions, tomato juice, lettuce, coffee, salsa, broccoli, bacon, and roast beef, were generally fatty, acidic, spicy, and roughage-based. 29 A high-fat solid meal significantly increased overall symptoms among individuals with gastroparesis. 30 On the other hand, saltine crackers, jello, and graham crackers moderately improved symptoms, and 12 additional foods were tolerated without provoking symptoms.…”

Section: Advances In Dietary Recommendationsmentioning

confidence: 99%

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Novel Diet, Drugs, and Gastric Interventions for Gastroparesis

Camilleri

2016

Clinical Gastroenterology and Hepatology

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This review of the pathophysiological basis for gastroparesis and recent advances in the treatment of patients with gastroparesis shows that there are several novel approaches to advance treatment of gastroparesis including diet, novel prokinetics, interventions on the pylorus, and novel forms of gastric electrical stimulation. The field of gastroparesis is likely to advance with further studies, with the help from a guidance document from the FDA on gastroparesis, and with the recent approval of the stable isotope gastric emptying test to ensure eligibility of participants in multicenter trials. Clinical experience and a formal, randomized, controlled trial provide insights on optimizing dietary interventions in patients with gastroparesis. This review addresses the biological rationale of these different treatments, based on known physiology and pathophysiology of gastric emptying. The novel medications include the motilin agonist, camicinal, 5-HT4 receptor agonists such as velusetrag, and the ghrelin agonist, relamorelin. New approaches target pylorospasm by either stent placement, endoscopic pyloric myotomy or laparoscopic pyloroplasty. These approaches offer the opportunity to achieve more permanent reduction of resistance to flow at the pylorus over the intrapyloric injection of botulinum toxin, which typically has to be repeated every few months if it is efficacious. A novel device, deployed in porcine stomach, involved per-endoscopic electrical stimulation. These promising approaches require formal, randomized, controlled trials and deployment in patients. The presence of concomitant antral hypomotility may be a significant factor in the responsiveness to interventions at the pylorus.

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Section: Advances In Dietary Recommendationsmentioning

confidence: 99%

“…These were: ginger ale, gluten-free foods, tea, sweet potatoes, pretzels, white fish, clear soup, salmon, potatoes, white rice, popsicles, and applesauce. 29 …”

Section: Advances In Dietary Recommendationsmentioning

confidence: 99%

Novel Diet, Drugs, and Gastric Interventions for Gastroparesis

Camilleri

2016

Clinical Gastroenterology and Hepatology

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“…Wytiaz et al [25] studied selfreported aggravation or alleviation by nutrients in 45 patients with gastroparesis (39 idiopathic), using food toleration and aversion rating questionnaires. Patients reported food substances, which they considered to aggravate (orange juice, fried chicken, cabbage, oranges, sausage, pizza, peppers, onions, tomato juice, lettuce, coffee, salsa, broccoli, bacon, and roast beef) or improve (saltine crackers, jello, and graham crackers) symptoms, and indicated good tolerance for a number of food items (ginger ale, gluten-free foods, tea, sweet potatoes, pretzels, white fish, clear soup, salmon, potatoes, white rice, popsicles, and applesauce) [25]. These data can be used as a basis for designing dietary interventions in gastroparesis.…”

Section: Dietary Interventionsmentioning

confidence: 99%

Gastroparesis

Tack

Carbone

Rotondo

2015

Current Opinion in Gastroenterology

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The relationship between delay in gastric emptying, symptom pattern, and response to prokinetic therapy in gastroparesis is poor. In diabetes, gastroparesis is characterized by loss of ICCs, and this is inversely correlated to the number of CD206+ macrophages. Dietary interventions may help to alleviate symptoms. Tricyclic antidepressants do not provide symptomatic benefit to patients with idiopathic gastroparesis.

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“…In addition, the skins prevent moisture loss from the scale surface and reduce respiration rate (Apeland, 1971). Although onion skins play an important role in postharvest onion storage and shelf life, knowledge of their formation is limited (Hole et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Cellular and Molecular Changes Associated with Onion Skin Formation Suggest Involvement of Programmed Cell Death

et al. 2017

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Skin formation of onion (Allium cepa L.) bulb involves scale desiccation accompanied by scale senescence, resulting in cell death and tissue browning. Understanding the mechanism of skin formation is essential to improving onion skin and bulb qualities. Although onion skin plays a crucial role in postharvest onion storage and shelf life, its formation is poorly understood. We investigated the mode of cell death in the outermost scales that are destined to form the onion skin. Surprisingly, fluorescein diacetate staining and scanning electron microscopy indicated that the outer scale desiccates from the inside out. This striking observation suggests that cell death in the outer scales, during skin formation, is an internal and organized process that does not derive only from air desiccation. DNA fragmentation, a known hallmark of programmed cell death (PCD), was revealed in the outer scales and gradually decreased toward the inner scales of the bulb. Transmission electron microscopy further revealed PCD-related structural alterations in the outer scales which were absent from the inner scales. De novo transcriptome assembly for three different scales: 1st (outer), 5th (intermediate) and 8th (inner) fleshy scales identified 2,542 differentially expressed genes among them. GO enrichment for cluster analysis revealed increasing metabolic processes in the outer senescent scale related to defense response, PCD processes, carbohydrate metabolism and flavonoid biosynthesis, whereas increased metabolism and developmental growth processes were identified in the inner scales. High expression levels of PCD-related genes were identified in the outer scale compared to the inner ones, highlighting the involvement of PCD in outer-skin development. These findings suggest that a program to form the dry protective skin exists and functions only in the outer scales of onion.

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Foods Provoking and Alleviating Symptoms in Gastroparesis: Patient Experiences

Cited by 52 publications

References 9 publications

Novel Diet, Drugs, and Gastric Interventions for Gastroparesis

Novel Diet, Drugs, and Gastric Interventions for Gastroparesis

Gastroparesis

Cellular and Molecular Changes Associated with Onion Skin Formation Suggest Involvement of Programmed Cell Death

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