Pathophysiology and pharmacotherapy of gastroparesis: current and future perspectives

@article{Stevens2013PathophysiologyAP,
  title={Pathophysiology and pharmacotherapy of gastroparesis: current and future perspectives},
  author={Julie E. Stevens and Karen L. Jones and Christopher K. Rayner and Michael Horowitz},
  journal={Expert Opinion on Pharmacotherapy},
  year={2013},
  volume={14},
  pages={1171 - 1186}
}
Introduction: Gastroparesis is an important clinical disorder characterised by delayed gastric emptying in the absence of mechanical outlet obstruction. Idiopathic, diabetes and postsurgical causes represent the most common aetiologies. The condition commonly manifests as upper gastrointestinal symptoms, including nausea, vomiting, postprandial fullness, early satiety, abdominal pain and bloating. Areas covered: This paper provides a review of the prevalence, pathophysiology and clinical… 
Safety of treatment for gastroparesis
TLDR
An overview of the safety of the available pharmacological therapies utilized in the treatment of gastroparetic symptoms specifically addressing thesafety of prokinetics, antiemetics, sensory neuromodulators and pain modifying agents is provided.
Pathophysiology, Aetiology and Treatment of Gastroparesis
TLDR
Novel prokinetic agents have shown initial promise in clinical trials, and new endoscopic techniques such as gastric per-oral endoscopic myotomy are emerging that may provide an option in refractory gastroparesis with the adage of reduced morbidity compared to surgical treatments.
[Gastroparesis - causes, diagnosis and treatment].
TLDR
The causes, assessment and treatment options of gastroparesis are elucidate, and the condition may have significant consequences for patients, entailing reduced quality of life, reduced workforce participation and a considerable need for health assistance.
Gastroparesis in children
  • S. Islam
  • Medicine
    Current opinion in pediatrics
  • 2015
TLDR
Treatment of gastroparesis consists of symptomatic relief with medication to counteract the nausea, emesis, pain, bloating, gastroesophageal reflux, early satiety, and improve gastric emptying.
Pathophysiology and Treatment of Gastrointestinal Motility Disorders in the Acutely Ill.
TLDR
There is a lack of evidence to guide drug therapy of ileus, but neither erythromycin nor metoclopramide appear to have a role, and several drugs, including ghrelin agonist, highly selective 5-hydroxytryptamine receptor agonists, and opiate antagonists are being studied in clinical trials.
Investigational drug therapies for the treatment of gastroparesis
TLDR
It is also important to note that different upper gastrointestinal disorders (gastroparesis, chronic unexplained nausea and vomiting, functional dyspepsia) are difficult to distinguish apart, suggesting wider therapeutic opportunity.
Current and Emerging Medical Therapies for Gastroparesis
TLDR
This chapter will review current treatment options, upcoming promising medications, and some of the hurdles in advancing the field forward in gastroparesis.
Gastrointestinal involvement in systemic sclerosis: diagnosis and management
TLDR
This review provides important updates in systemic sclerosis (SSc)-related gastrointestinal disease, with a particular focus on the diagnosis and management of dysmotility.
Rectal Sensitivity in Diabetes Patients with Symptoms of Gastroparesis
TLDR
In patients with signs and symptoms of diabetic gastroparesis, rectal sensitivity was reduced, and heart rate variability was impaired, suggesting diabetic autonomic neuropathy as a diffuse disorder.
Prokinetics in Treatment of Gastric Motility Disorders
Congenital abnormalities, postsurgical and medical conditions such as gastroparesis, gastric arrhythmias, myenteric neuropathies, functional dyspepsia and Parkinson’s diseases to name a few have the
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 141 REFERENCES
Management of gastroparesis
  • W. Hasler
  • Medicine
    Expert review of gastroenterology & hepatology
  • 2008
TLDR
Management of idiopathic gastroparesis relies primarily on therapies that accelerate gastric emptying or reduce vomiting, although endoscopic or surgical options are available for refractory cases.
Pathophysiology and management of gastroparesis
TLDR
Gastroparesis is characterized by upper gastrointestinal symptoms associated with delayed gastric emptying, without mechanical obstruction, and probably represents a major cause of poor glycemic control in diabetics.
Bloating in Gastroparesis: Severity, Impact, and Associated Factors
TLDR
Findings provide insight into this underappreciated symptom of gastroparesis and suggest antiemetics, probiotics, and antidepressants with significant norepinephrine reuptake inhibitor activity may affect reports of bloating.
The Treatment of Diabetic Gastroparesis With Botulinum Toxin Injection of the Pylorus
TLDR
Botulinum toxin injection of the pylorus is safe and improves symptoms in patients with diabetic gastroparesis, and these results warrant further investigation with a large, double-blind, placebo-controlled trial.
Phenotypic switching in diabetic gastroparesis: mechanism directs therapy.
TLDR
It is now quite clear that not all of the symptoms reported by patients with diabetic gastroparesis are due to delayed gastric emptying, and patient symptoms may switch over time, suggesting that different pathophysiologic mechanisms may predominate at different times.
Effect of metoclopramide in diabetic gastroparesis.
TLDR
It is concluded that metoclopramide is an important therapeutic adjunct in the management of diabetic gastroparesis and its therapeutic effects are mediated through its prokinetic properties as well as centrally mediated antiemetic actions.
Abdominal pain is a frequent symptom of gastroparesis.
Prokinetics in Patients with Gastroparesis: A Systematic Analysis
TLDR
The data suggest that the motilin-agonist erythromycin is superior with regard to the acceleration of gastric emptying, while both eryhromycin and domperidone appear to be the most effective with regardto improvements in the symptom score.
Updates on treatment of irritable bowel syndrome.
TLDR
A physiologically-based overview of recently developed and frequently employed pharmaceutical agents used to treat IBS is provided, and some non-pharmaceutical options that may be beneficial in this disorder are discussed.
...
1
2
3
4
5
...