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Gastroparesis

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https://www.readbyqxmd.com/read/28644345/yield-of-endoscopy-in-pediatric-gastroparesis
#1
Tara A Altepeter, Stephen Shaffer
OBJECTIVES: The aim of the study was to quantify the diagnostic yield of upper endoscopy in children with gastroparesis and to develop a clinical model for gastroparesis using common symptoms and screening blood tests. METHODS: We retrospectively reviewed charts of 196 patients of age 4 to 18 years evaluated for gastroparesis between 2009 and 2013. All patients completed a standard solid-phase gastric emptying scan and upper endoscopy within a 12-month period. We analyzed gross and histologic endoscopy findings...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28639130/vitamin-c-improves-gastroparesis-in-diabetic-rats-effects-on-gastric-contractile-responses-and-oxidative-stress
#2
Luisa Mota Da Silva, Rita de Cássia Melo Vilhena de Andrade Fonseca da Silva, Daniele Maria-Ferreira, Olair Carlos Beltrame, José Eduardo da Silva-Santos, Maria Fernanda de Paula Werner
BACKGROUND: Diabetic gastroparesis is a common complication of diabetes mellitus, which mainly affects women. Previous studies have demonstrated that oxidative stress is involved in its onset and development. AIMS: This study evaluated the role of vitamin C on diabetes-associated gastric dysmotility. METHODS: Female rats with streptozotocin-induced diabetes were treated with vehicle (water, 1 mL/kg, p.o.), vitamin C (300 mg/kg/day, p.o.), or insulin (6 IU/day, s...
June 21, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28636760/successful-management-of-refractory-diabetic-gastroparesis-with-long-term-aprepitant-treatment
#3
N Fountoulakis, J Dunn, S Thomas, J Karalliedde
BACKGROUND: People with gastroparesis who develop treatment-resistant (refractory) disease pose a difficult challenge, especially in the setting of end-stage renal disease (ESRD) or post pancreas transplant. Aprepitant (a neurokinin-receptor antagonist) is licensed for the short-term treatment of chemotherapy-induced nausea. There is lack of information on its long-term efficacy and safety in people with diabetic gastroparesis. CASE REPORT: Case 1 was 73-year-old man with Type 2 diabetes of 25 years' duration and ESRD requiring dialysis...
June 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28627597/significance-of-dynamic-changes-in-gastric-smooth-muscle-cell-apoptosis-pi3k-akt-mtor-and-ampk-mtor-signaling-in-a-rat-model-of-diabetic-gastroparesis
#4
Mo-Han Zhang, Jing-Zhi Jiang, Ying-Lan Cai, Li-Hua Piao, Zheng Jin
The aim of the present study was to investigate the significance of cell apoptosis, the phosphoinositide-3-kinase (PI3K)-protein kinase B (AKT)-mammalian target of rapamycin (mTOR) pathway, and the 5' adenosine monophosphate-activated protein kinase (AMPK)‑mTOR pathways in the process of diabetic gastroparesis. Changes in gastric smooth muscle cells of diabetic rats with induced gastroparesis were examined. The diabetic rat model was established by dividing animals into a normal control group and diabetic model groups examined at 2, 4 and 6 weeks...
June 13, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28588153/gastric-dilatation-and-abdominal-compartment-syndrome-in-a-child-with-prader-willi-syndrome
#5
Clara Blat, Elisenda Busquets, Teresa Gili, Assumpta Caixàs, Elisabeth Gabau, Raquel Corripio
BACKGROUND Prader-Willi syndrome (PWS) is a genetic disorder characterized by initial muscular hypotonia and feeding difficulties, and later an insatiable appetite, hyperphagia and obesity along with mild to moderate intellectual impairment. Affected individuals' food-seeking behavior and suspected delayed gastric emptying can lead to gastric dilatation with subsequent necrosis and perforation. CASE REPORT We present the case of a 5-year-old boy diagnosed with Prader-Willi syndrome at neonatal age due to muscular hypotonia, who started growth hormone therapy at 20 months...
June 7, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28577248/pathological-findings-of-the-antral-and-pyloric-smooth-muscle-in-patients-with-gastroparesis-like-syndrome-compared-to-gastroparesis-similarities-and-differences
#6
Mohammad Bashashati, Sharareh Moraveji, Alireza Torabi, Irene Sarosiek, Brian R Davis, Jesus Diaz, Richard W McCallum
BACKGROUND: Gastroparesis (GP)-like syndrome presents with the symptoms of GP but without delayed gastric emptying (GE). Whether GP-like syndrome is part of a spectrum of GP is not clear. This study aimed to compare the histopathological features of antral and pyloric smooth muscle tissue in GP and GP-like syndrome. METHODS: Full-thickness antral and/or pyloric biopsies were obtained from 37 GP and 18 GP-like syndrome patients who underwent abdominal surgery to place a gastric electrical stimulator or jejunal feeding tube and/or pyloroplasty...
June 2, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28577245/from-harmful-treatment-to-secondary-gain-adverse-event-reporting-in-dyspepsia-and-gastroparesis
#7
Klaus Bielefeldt
INTRODUCTION: Medical management of gastroparesis and functional dyspepsia remains difficult with several recent trials showing limited or no benefit. If treatment comes with only marginal improvements, concerns about adverse events become more relevant. We therefore examined the type and outcomes of side effects submitted to a public repository. METHODS: We searched the Federal Adverse Event Reporting System for reports associated with the treatment of dyspepsia or gastroparesis...
June 2, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28567693/per-oral-endoscopic-pyloromyotomy-for-refractory-gastroparesis-initial-results-from-a-single-institution
#8
John H Rodriguez, Ivy N Haskins, Andrew T Strong, Ryan L Plescia, Matthew T Allemang, Robert S Butler, Michael S Cline, Kevin El-Hayek, Jeffrey L Ponsky, Matthew D Kroh
INTRODUCTION: Gastroparesis is a debilitating disease characterized by delayed gastric emptying in the absence of mechanical obstruction. A new intramural technique, per oral endoscopic pyloromyotomy (POP), has been proposed as an alternative to surgical pyloroplasty for the management of medical refractory gastroparesis. Herein, we detail the short-term results of POP at our institution. METHODS: POP was first performed at our institution in January 2016. All patients undergoing POP for management of gastroparesis from January 2016 through January 2017 were prospectively followed...
May 31, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28535580/gastroparesis-updates-on-pathogenesis-and-management
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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 also occurs 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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