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Gastroparesis

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https://www.readbyqxmd.com/read/28535580/gastroparesis-updates-on-pathogenesis-and-management
#1
REVIEW
Nanlong Liu, Thomas Abell
Gastroparesis (Gp) is a chronic disease that presents with clinical symptoms of early satiety, bloating, nausea, vomiting, and abdominal pain. Along with these symptoms, an objective finding of delayed gastric emptying, along with a documented absence of gastric outlet obstruction, are required for diagnosis. This article focuses on updates in the pathogenesis and management of Gp. Recent studies on full thickness biopsies of Gp patients have shed light on the complex interactions of the central, autonomic, and enteric nervous systems, which all play key roles in maintaining normal gut motility...
May 25, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28504312/g-poem-with-antro-pyloromyotomy-for-the-treatment-of-refractory-gastroparesis-mid-term-follow-up-and-factors-predicting-outcome
#2
J M Gonzalez, A Benezech, V Vitton, M Barthet
BACKGROUND: Gastric peroral endoscopic pyloromyotomy (G-POEM) was introduced for treating refractory gastroparesis. AIM: The presented series focused on clinical mid-term efficacy and predictive outcomes factors. METHODS: This was a single centre study of 29 patients operated on between January 2014 and April 2016, with disturbed gastric emptying scintigraphy (GES) and/or elevated Gastroparesis Cardinal Symptoms Index (GCSI). The procedures were performed as previously described...
May 15, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28483605/intramural-surgery-a-new-vista-in-minimally-invasive-therapy
#3
Andrew T Strong, John Rodriguez, Matthew Kroh, Jeffrey L Ponsky
Endoscopic therapy for lesions of the gastrointestinal tract has become commonplace. Endoscopic excision of polyps was introduced over four decades ago. Today, removal of large, sessile lesions by means of endoscopic mucosal resection or endoscopic submucosal dissection is increasingly employed throughout the gastrointestinal tract. A decade ago, the concept of trans-lumenal endoscopic surgery was introduced. Although not widely practiced, it ushered in development of new concepts and technology which have contributed extensively to the growth of endoscopic and laparoscopic surgical practice...
May 5, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28481694/pyloroplasty-offers-relief-of-postfundoplication-gastroparesis-in-patients-who-improved-after-botulinum-toxin-injection
#4
Daniel Gilsdorf, Eric Volckmann, Abbie Brickley, Linda Jo Taylor, Robert E Glasgow, John Fang
BACKGROUND: Endoscopic intrapyloric Botox (onabotulinumtoxin A; Allergan Pharmaceuticals) injections can improve postfundoplication gastroparesis, but responses are not durable. Surgical pyloroplasty may relieve gastroparetic symptoms, but patient selection criteria are poorly defined. We hypothesize that pyloroplasty provides durable improvement in patients whose symptoms improved after Botox injection. STUDY DESIGN: A retrospective chart review was performed of patients with postfundoplication gastroparesis who improved after Botox injection and then underwent pyloroplasty...
May 8, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28457416/abdominal-complications-after-lung-transplantation-in-a-brazilian-single-center
#5
H F Costa, F P Dos Reis, O Gomes-Junior, L M Fernandes, L G Abdalla, S V Campos, R H O B Teixeira, M N Samano, P M Pêgo-Fernandes
Surgical and nonsurgical abdominal complications have been described after lung transplantation. However, there is limited data on this event in this population. The objective of this study was to analyze the incidence of abdominal complications in patients undergoing lung transplantation at the Heart Institute of the Faculty of Medicine, University of São Paulo (InCor-HCFMUSP) between the years 2003 and 2016. The main causes of abdominal complications were inflammatory acute abdomen (7 patients; 14%), obstructive acute abdomen (9 patients; 18%), gastroparesis (4 patients; 8%), distal intestinal obstruction syndrome (4 patients; 8%), perforated acute abdomen (7 patients; 14%), cytomegalovirus (CMV; 6 patients; 12%), and other reasons (12 patients; 26%)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28438610/hyperglycemia-increases-interstitial-cells-of-cajal-via-mapk1-and-mapk3-signaling-to-etv1-and-kit-leading-to-rapid-gastric-emptying
#6
Yujiro Hayashi, Yoshitaka Toyomasu, Siva Arumugam Saravanaperumal, Michael R Bardsley, John A Smestad, Andrea Lorincz, Seth T Eisenman, Gianluca Cipriani, Molly H Nelson Holte, Fatimah J Al Khazal, Sabriya A Syed, Gabriella B Gajdos, Kyoung Moo Choi, Gary J Stoltz, Katie E Miller, Michael L Kendrick, Brian P Rubin, Simon J Gibbons, Adil E Bharucha, David R Linden, Louis James Maher, Gianrico Farrugia, Tamas Ordog
BACKGROUND & AIMS: Depletion of interstitial cells of Cajal (ICCs) is common in diabetic gastroparesis. However, in approximately 20% of patients with diabetes, gastric emptying (GE) is accelerated. GE is also faster in obese individuals, and is associated with increased blood levels of glucose in patients with type 2 diabetes. To understand the fate of ICCs in hyperinsulinemic, hyperglycemic states characterized by rapid GE, we studied mice with mutation of the leptin receptor (Lepr(db/db)), which in our colony had accelerated GE...
April 21, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28413522/electroacupuncture-combined-with-mosapride-alleviates-symptoms-in-diabetic-patients-with-gastroparesis
#7
Wenping Pan, Zhankui Wang, Feilong Tian, Mingxian Yan, Yan Lu
The present study compared the clinical effectiveness of electroacupuncture (EA), monotherapy and combination therapy involving the administration of EA and mosapride in diabetic patients with severe or mild symptoms suggestive of gastroparesis. A total of 56 patients with type 2 diabetes who had symptoms suggestive of gastroparesis for >3 months were divided into two groups according to the Gastroparesis Cardinal Symptom Index (GCSI) score, including 33 in the mild group (GCSI score <3.5) and 23 in the severe group (GCSI score ≥3...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28410896/gastroparesis-clinical-and-regulatory-insights-for-clinical-trials
#8
Pankaj J Pasricha, Michael Camilleri, William L Hasler, Henry P Parkman
Gastroparesis continues to represent a large unmet clinical need and a major opportunity for new drug development. This has led to increasing interest by federal funding agencies, regulatory bodies, and industry. This article summarizes the proceedings of the gastroparesis section of the "Drug Development Conference: Clinical Endpoints in Upper GI Disorders" organized by the American Gastroenterological Association in Washington, DC, on October 27-28, 2016. The presentation, diagnosis, and current therapeutic strategies are briefly reviewed, followed by a detailed discussion of the regulatory strategy, recommended endpoints, and future directions...
April 12, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28409375/fluoroscopy-guided-gastric-peroral-endoscopic-pyloromyotomy-g-poem-a-more-reliable-and-efficient-method-for-treatment-of-refractory-gastroparesis
#9
H B Xue, H Z Fan, X M Meng, S Cristofaro, P Mekaroonkamol, S Dacha, L Y Li, X L Fu, S H Zhan, Q Cai
INTRODUCTION: Prior studies show promising results of the gastric peroral endoscopic pyloromyotomy (G-POEM) procedure for treatment of refractory gastroparesis. One major technical challenge involved in this procedure is identifying the pyloric muscular ring (PMR). The aim of this study is to establish a reliable method for identification of the PMR during G-POEM. METHODS: Fluoroscopy-guided G-POEM was performed by placing an endoclip at the 9 to 11'o clock position at the pylorus for identification of PMR...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28408802/mirtazapine-for-symptom-control-in-refractory-gastroparesis
#10
Mark Malamood, Aaron Roberts, Rahul Kataria, Henry P Parkman, Ron Schey
INTRODUCTION: Gastroparesis symptoms can be severe and debilitating. Many patients do not respond to currently available treatments. Mirtazapine has been shown in case reports to reduce symptoms in gastroparesis. AIM: To assess the efficacy and safety of mirtazapine in gastroparetic patients. METHODS: Adults with gastroparesis and poorly controlled symptoms were eligible. Participants were prescribed mirtazapine 15 mg PO qhs. Questionnaires containing the gastrointestinal cardinal symptom index (GCSI) and the clinical patient grading assessment scale (CPGAS) were completed by patients' pretreatment, at 2 weeks, and at 4 weeks...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28408641/gastroparesis-and-lipid-metabolism-associated-dysbiosis-in-wistar-kyoto-rats
#11
Julie E Dalziel, Karl Fraser, Wayne Young, Catherine M Lloyd-West, Shalome A Bassett, Nicole C Roy
Altered gastric accommodation and intestinal morphology suggests impaired gastrointestinal (GI) transit may occur in the Wistar Kyoto (WKY) rat strain, as common in stress-associated functional GI disorders. Because changes in GI transit can alter microbiota composition, we investigated whether these are altered in WKY rats compared with the resilient Sprague Dawley (SD) rats under basal conditions, and characterized plasma lipid and metabolite differences. Bead transit was tracked by X-ray imaging to monitor: gastric emptying (GE; 4 h), small intestine (SI) transit (9 h) and large intestine transit (12 h)...
April 13, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28398233/therapeutic-potential-of-targeting-the-ghrelin-pathway
#12
REVIEW
Gustav Colldén, Matthias H Tschöp, Timo D Müller
Ghrelin was discovered in 1999 as the endogenous ligand of the growth-hormone secretagogue receptor 1a (GHSR1a). Since then, ghrelin has been found to exert a plethora of physiological effects that go far beyond its initial characterization as a growth hormone (GH) secretagogue. Among the numerous well-established effects of ghrelin are the stimulation of appetite and lipid accumulation, the modulation of immunity and inflammation, the stimulation of gastric motility, the improvement of cardiac performance, the modulation of stress, anxiety, taste sensation and reward-seeking behavior, as well as the regulation of glucose metabolism and thermogenesis...
April 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28386945/post-hoc-subanalysis-of-two-randomized-controlled-phase-3-trials-evaluating-diclofenac-potassium-for-oral-solution-impact-of-migraine-associated-nausea-and-prior-triptan-use-on-efficacy
#13
Richard B Lipton, Pete Schmidt, Hans-Christoph Diener
OBJECTIVE: To determine whether baseline nausea or prior triptan treatment for migraine impact the effectiveness of diclofenac potassium for oral solution in treating acute migraine. BACKGROUND: A great deal of variability exists in patients' response to migraine medications. Migraine-associated nausea is common and debilitating and can reduce the effectiveness of oral medications. It may cause patients to delay taking oral medications, which is known to diminish therapeutic outcomes, or to avoid taking them altogether...
May 2017: Headache
https://www.readbyqxmd.com/read/28374487/gastric-neuromuscular-histology-in-patients-with-refractory-gastroparesis-relationships-to-etiology-gastric-emptying-and-response-to-gastric-electric-stimulation
#14
J Heckert, R M Thomas, H P Parkman
BACKGROUND: The aims of this study were to describe the histology in gastroparesis, specifically to relate histopathology to etiology of gastroparesis (idiopathic and diabetic gastroparesis), gastric emptying, and clinical response to gastric electric stimulation. METHODS: Full thickness gastric body sections obtained during insertion of gastric stimulator in gastroparetics were stained with Hematoxylin & Eosin, Masson Trichrome and immunohistochemical stains for Neuron-Specific Enolase and c-Kit...
April 4, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28362659/neuroleptic-malignant-syndrome-secondary-to-metoclopramide-use-in-an-elderly-gastroenterologic-surgery-patient
#15
Richard Breeden, Heath Ford, Carey Chrisman, Charles Mascioli
An 84-year-old African American woman was admitted to the hospital secondary to severe abdominal pain accompanied by septic shock. She underwent exploratory laparotomy, which revealed extensive small bowel necrosis likely due to small bowel torsion. A small bowel resection was performed with primary anastomoses and the patient was subsequently transferred to the intensive care unit (ICU). She recovered from shock but had a persistent gastroparesis interfering with enteral feeding, for which metoclopramide was prescribed...
March 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28336106/nomogram-for-predicting-oral-feeding-intolerance-in-patients-with-acute-pancreatitis
#16
Melody G Bevan, Varsha M Asrani, Sayali A Pendharkar, Rachel L Goodger, John A Windsor, Maxim S Petrov
OBJECTIVES: Oral feeding intolerance (OFI) is a common complication of acute pancreatitis that leads to prolonged hospitalization, increased use of hospital resources, and impaired quality of life. However, there are no clinically useful predictors of OFI. The aims of this study were to determine whether gastrointestinal dysmotility is associated with the development of OFI, and whether the gastroparesis cardinal symptom index (GCSI) can be used as a predictive tool in a clinical setting...
April 2017: Nutrition
https://www.readbyqxmd.com/read/28321329/utility-of-the-wireless-motility-capsule-and-lactulose-breath-testing-in-the-evaluation-of-patients-with-parkinson-s-disease-who-present-with-functional-gastrointestinal-symptoms
#17
Andrew Su, Rita Gandhy, Carrolee Barlow, George Triadafilopoulos
BACKGROUND: The aetiology and origin of gastrointestinal symptoms in Parkinson's disease (PD) remains poorly understood. Gastroparesis, small bowel transit delay and bacterial overgrowth may, individually or collectively, play a role. AIMS: In patients with PD and functional gastrointestinal symptoms, we aimed to determine the utility of the wireless motility capsule and lactulose breath tests in further defining their symptoms' aetiology. METHODS: In this retrospective cohort study, consecutive patients with PD and functional gastrointestinal symptoms underwent clinical assessment, as well as wireless motility capsule and lactulose breath testing using standard protocols...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28320545/haloperidol-undermining-gastroparesis-symptoms-hugs-in-the-emergency-department
#18
Rene Ramirez, Philip Stalcup, Brandon Croft, Michael A Darracq
BACKGROUND: Gastroparesis associated nausea, vomiting & abdominal pain (GP N/V/AP) are common presentations to the emergency department (ED). Treatment is often limited to antiemetic, prokinetic, opioid, & nonopioid agents. Haloperidol (HP) has been shown to have analgesic & antiemetic properties. We sought to evaluate HP in the ED as an alternative treatment of GP N/V/AP. METHODS: Using an electronic medical record, 52 patients who presented to the ED w/GP N/V/AP secondary to diabetes mellitus and were treated w/HP were identified...
March 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28319561/pediatric-enteric-neuropathies-diagnosis-and-current-management
#19
Maggie L Westfal, Allan M Goldstein
PURPOSE OF REVIEW: Neurointestinal diseases are increasingly recognized as causes of significant gastrointestinal morbidity in children. This review highlights the most common pediatric enteric neuropathies and their diagnosis and management, emphasizing insights and discoveries from the most recent literature available. RECENT FINDINGS: The embryologic and histopathologic causes of enteric neuropathies are varied. They range from congenital aganglionosis in Hirschsprung disease, to autoimmune-mediated loss of neuronal subtypes in esophageal achalasia and Chagas disease, to degenerative neuropathies in some cases of chronic intestinal pseudo-obstruction and gastroparesis...
June 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28291006/assessment-of-the-prevalence-of-diabetic-gastroparesis-and-validation-of-gastric-emptying-scintigraphy-for-diagnosis
#20
Zeinab Alipour, Foad Khatib, Seyed Masoud Tabib, Hamid Javadi, Esmail Jafari, Leila Aghaghazvini, Ali Mahmoud-Pashazadeh, Iraj Nabipour, Majid Assadi
OBJECTIVE: Gastroparesis is defined as delayed gastric emptying and is a common medical condition in diabetic patients. Scintigraphy is commonly used as a standard diagnostic procedure for the quantitative assessment of gastroparesis. The aims of this study were to determine an optimum imaging time for the diagnosis of gastroparesis, to assess the prevalence of gastroparesis, to evaluate the correlation between endoscopy and scintigraphy findings as well as the correlation between gastric emptying with patient genders, blood glucose concentration, and functional dyspepsia...
February 5, 2017: Molecular Imaging and Radionuclide Therapy
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