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Review article: gastroparesis
Author(s) -
PATRICK A.,
EPSTEIN O.
Publication year - 2008
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2008.03637.x
Subject(s) - gastroparesis , medicine , gastric emptying , neurostimulation , metoclopramide , intensive care medicine , nausea , vomiting , stomach , stimulation
Summary Background Gastroparesis is a chronic disorder caused by stomach pump failure and characterized by profound nausea, vomiting and epigastric pain. Most often, the cause is unapparent and of the known associations, diabetes is the most common. Diagnosis is usually made using an isotope‐labelled test meal. Treatment is incremental and includes education, dietary support, prokinetic and antiemetic agents. There are novel approaches including gastric neurostimulation. Aim To review current concepts of gastric motor function, aetiology, investigation and treatment of gastroparesis. Methods A systematic web‐based review of the literature was undertaken using a lexicon of terms associated with gastroparesis. Results There are few controlled studies of this condition. Little is known about causation or underlying nerve, muscle or pacemaker pathology. Idiopathic gastroparesis occurs most commonly in women and gastric emptying is often abnormal in diabetes. Isotopic gastric scintigraphy remains the gold standard investigation, but alternative tests are being developed. Treatment is multimodal and includes education, and nutritional support. There are no adequately powered controlled trials to support a particular drug regimen. In intractable gastroparesis, gastric neurostimulation appears to offer benefit. Conclusion Despite a significant progress in the past decade, further controlled trials are required into the therapeutic options available for treating this intriguing condition.