Symposium on upper gastrointestinal motility disorders. Gastric motor disorders: an overview

Disturbances of gastric emptying are being increasingly recognized as causes of clinical problems such as chronic nausea, vomiting, and abdominal pain. Although much remains to be learned, enough information is available to enable the practicing physician to develop an approach to diagnosis and management of these often difficult problems. We review here relevant physiologic concepts of gastric motor activity during fasting and feeding, as well as its controlling mechanisms. These concepts are then applied to develop a rational classification of gastric motor disorders which incorporates clinical as well as pathophysiologic information. Further, we review pertinent diagnostic studies (including gastric emptying tests, manometry, and electrophysiologic measurements) and therapeutic approaches.