Gastroparesis: approach, diagnostic evaluation, and management

Area of Science:

• Gastroenterology
• Motility Disorders
• Medical Research

Background:

• Gastroparesis is a chronic stomach motility disorder characterized by delayed gastric emptying.
• The exact cause is often unknown, but it can be a complication of diabetes mellitus, scleroderma, or abdominal surgeries.
• Pathophysiology involves the autonomic nervous system, smooth muscle cells, and enteric neurons.

Purpose of the Study:

• To provide an overview of gastroparesis, including its pathophysiology, symptoms, diagnosis, and treatment options.
• To highlight current and emerging therapeutic strategies for managing gastroparesis.
• To discuss future research directions in gastroparesis treatment.

Main Methods:

• Diagnosis involves upper endoscopy to exclude mechanical obstruction, followed by gastric emptying scintigraphy.
• Alternative diagnostic methods include wireless capsule motility, antroduodenal manometry, and breath testing.
• Treatment approaches range from dietary modifications and pharmacotherapy to invasive interventions.

Main Results:

• Common symptoms include nausea, vomiting, postprandial fullness, and early satiety.
• Severe cases can lead to complications like bezoars.
• Treatment efficacy varies, often requiring adjustments in medications or interventions.

Conclusions:

• Gastroparesis management requires a multi-faceted approach tailored to individual patient needs.
• Emerging therapies like hemin, advanced gastric electrical stimulation, regenerative medicine, and stem cell-based treatments show promise.
• Continued research is crucial for improving outcomes in patients with gastroparesis.