Gastroparesis: concepts, controversies, and challenges

Area of Science:

• Gastroenterology
• Neurogastroenterology
• Functional Gastrointestinal Disorders

Background:

• Gastroparesis significantly impacts patients' quality of life due to symptoms like nausea and vomiting.
• Current treatments for impaired gastric emptying are limited and often ineffective.
• Parallels with other functional gastrointestinal disorders suggest brain-targeted therapies may be beneficial.

Purpose of the Study:

• To explore emerging treatment strategies for gastroparesis.
• To investigate the potential of therapies targeting the central nervous system for gastroparesis.
• To understand the complex mechanisms underlying gastroparesis beyond delayed gastric emptying.

Main Methods:

• Review of current literature on gastroparesis pathophysiology and treatment.
• Analysis of studies investigating therapies targeting visceral sensory processing.
• Consideration of physiological and anatomical investigations into gastroparesis mechanisms.

Main Results:

• Gastric electrical stimulation may modulate visceral sensory processing rather than solely altering gastric motility.
• Diverse mechanisms contribute to gastroparesis, including impaired accommodation, visceral hypersensitivity, and neural inflammation.
• Delayed gastric emptying remains the defining characteristic, but treatment is evolving.

Conclusions:

• Treatment for gastroparesis is shifting towards therapies that may influence brain-gut interactions.
• Gastric electrical stimulation offers a potential new avenue by affecting sensory processing.
• Improved understanding of gastroparesis mechanisms may lead to better quality of life for patients.