Treatment of gastroparesis: a multidisciplinary clinical review

Abell, Thomas L.; Bernstein, R. K.; Cutts, Teresa; Farrugia, Gianrico; Forster, Jameson; Hasler, William L.; McCallum, Richard W.; Olden, Kevin W.; Parkman, Henry P.; Parrish, Carol Rees; Pasricha, P. J.; Prather, Charlene M.; Soffer, E. E.; Twillman, Robert K.; Ai, Vinik

doi:10.1111/j.1365-2982.2006.00760.x

Cited by 306 publications

(101 citation statements)

References 161 publications

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“…Another simple gradation of severity is outlined in table 1[9]. Grade 1 usually includes patients with mild intermittent symptoms that are controlled with diet modification and avoidance of exacerbating agents.…”

Section: Assessment Of Severitymentioning

confidence: 99%

“…Psychotherapeutic measures like relaxation techniques have been useful. Some patients benefit from hypnosis and biofeedback [9]. …”

Section: Treatmentmentioning

confidence: 99%

“…Nonsteroidal agents, selective serotonin reuptake inhibitors and opiates have been used with varying degrees of success [9]. …”

Section: Treatmentmentioning

confidence: 99%

“…The most commonly used antiemetic drugs are the phenothiazines (for example prochlorperazine and thiethylperazine) and they can be used in conjunction with prokinetic agents [9]. …”

Section: Treatmentmentioning

confidence: 99%

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Treatment of Gastroparesis: An Update

Gumaste

Baum²

2008

Digestion

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Gastroparesis is a chronic disorder of gastric motility that is characterized by delayed emptying of either solids or liquids from the stomach in the absence of any mechanical obstruction. Nausea, vomiting, early satiety and bloating are some of the manifestations of gastroparesis. Idiopathic, diabetes mellitus and postsurgical states account for the majority of cases. Gastroparesis is a difficult condition to treat. Prokinetic drugs like metoclopramide and erythromycin form the mainstay of therapy but are less than ideal. Some patients may benefit from endoscopic botolinium toxin injection. Gastric electrical stimulation, though promising, is not ready for prime time yet.

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Section: Assessment Of Severitymentioning

confidence: 99%

“…Psychotherapeutic measures like relaxation techniques have been useful. Some patients benefit from hypnosis and biofeedback [9]. …”

Section: Treatmentmentioning

confidence: 99%

“…Nonsteroidal agents, selective serotonin reuptake inhibitors and opiates have been used with varying degrees of success [9]. …”

Section: Treatmentmentioning

confidence: 99%

“…The most commonly used antiemetic drugs are the phenothiazines (for example prochlorperazine and thiethylperazine) and they can be used in conjunction with prokinetic agents [9]. …”

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Treatment of Gastroparesis: An Update

Gumaste

Baum²

2008

Digestion

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“…The reported prevalence of gastroparesis in adults varies widely, ranging from ~ 0.04% to 4%. 1–4 The pediatric prevalence of gastroparesis is unknown.…”

mentioning

confidence: 99%

Relationship of Gastrointestinal Symptoms and Psychosocial Distress to Gastric Retention in Children

Wong

Shulman

Malaty

et al. 2014

The Journal of Pediatrics

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Objectives To determine whether gastrointestinal (GI) symptoms (abdominal pain, non-pain GI symptoms, nausea) and/or psychosocial distress differ between children with/without gastroparesis, and secondarily whether the severity of GI symptoms and/or psychosocial distress are related to the degree of gastroparesis. Study design Children 7 – 18 yr. of age (n=100; 63 female) undergoing a 4-hour gastric emptying scintigraphy (GES) study completed questionnaires evaluating GI symptoms, anxiety, and somatization for this prospective study. Spearman correlation, Mann-Whitney, t-test, and chi-square tests were utilized as appropriate for statistical analysis. Results Children with gastroparesis (n=25) were younger than those with normal emptying (12.6 ± 3.5 yr. vs. 14.3 ± 2.6, P=0.01). Because questionnaire responses from 7–10-year-old children were inconsistent, only patient-reported symptoms from 11–18-year-olds were used. Within this older group (n=83), children with gastroparesis (n=17) did not differ from children with normal emptying in severity of GI symptoms or psychosocial distress. In children with gastroparesis, gastric retention at 4 hr was related inversely to vomiting (r=−0.506, P=0.038), nausea (r=−0.536, P=0.019), difficulty finishing a meal (r=−0.582, P=0.014), and CSI-24 score (r=−0.544, P=0.024) and positively correlated with frequency of waking from sleep with symptoms (r=0.551, P=0.022). Conclusions The severity of GI symptoms and psychosocial distress do not differ between children with/without gastroparesis who are undergoing GES. In those with gastroparesis, gastric retention appears to be inversely related to dyspeptic symptoms and somatization, and positively related to waking from sleep with symptoms.

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