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Gastroparesis

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https://www.readbyqxmd.com/read/29782470/characterizing-abdominal-pain-in-patients-with-gastroparesis-into-neuropathic-and-nociceptive-components
#1
Asad Jehangir, Rany T Abdallah, Henry P Parkman
INTRODUCTION: The cause of abdominal pain (AP) in gastroparesis (Gp) is often not known; hence, its treatment can be challenging. Preoccupation with or increased attention (hypervigilance) to pain is associated with perceived pain severity and psychosocial disability. The aims of this study were to (1) characterize AP in Gp patients into neuropathic and nociceptive pain components; (2) assess these patients for hypervigilance to pain. MATERIALS AND METHODS: Gp patients with AP as an important symptom, seen from June 2017 to November 2017 were given validated questionnaires to characterize their AP...
May 18, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29780600/fluoroscopic-gastric-peroral-endoscopic-pyloromyotomy-g-poem-in-patients-with-a-failed-gastric-electrical-stimulator
#2
Abhinav Koul, Sunil Dacha, Parit Mekaroonkamol, Xiaoyu Li, Lianyong Li, Nikrad Shahnavaz, Steven Keilin, Field F Willingham, Jennifer Christie, Qiang Cai
Background: Gastric electrical stimulators (GESs) have been used to treat refractory gastroparesis in patients who fail initial therapies such as dietary modifications, control of psychological stressors and pharmacologic treatment. More recently, gastric peroral endoscopic pyloromyotomy (G-POEM) has emerged as a novel endoscopic technique to treat refractory gastroparesis. We present a case series of patients with refractory gastroparesis who failed treatment with an implanted GES that were safely treated with G-POEM performed under fluoroscopy as a salvage therapy...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29766276/anti-ganglionic-achr-antibodies-in-japanese-patients-with-motility-disorders
#3
Akihiro Mukaino, Hitomi Minami, Hajime Isomoto, Hitomi Hamamoto, Eikichi Ihara, Yasuhiro Maeda, Osamu Higuchi, Tohru Okanishi, Yohei Kokudo, Kazushi Deguchi, Fumisato Sasaki, Toshihito Ueki, Ken-Ya Murata, Takeshi Yoshida, Mistuyo Kinjo, Yoshihiro Ogawa, Akio Ido, Hidenori Matsuo, Kazuhiko Nakao, Shunya Nakane
BACKGROUND: The existence of several autoantibodies suggests an autoimmune basis for gastrointestinal (GI) dysmotility. Whether GI motility disorders are features of autoimmune autonomic ganglionopathy (AAG) or are related to circulating anti-ganglionic acetylcholine receptor (gAChR) antibodies (Abs) is not known. The aim of this study was to determine the associations between autonomic dysfunction, anti-gAChR Abs, and clinical features in patients with GI motility disorders including achalasia and chronic intestinal pseudo-obstruction (CIPO)...
May 15, 2018: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29760572/breath-powered-sumatriptan-dry-nasal-powder-an-intranasal-medication-delivery-system-for-acute-treatment-of-migraine
#4
REVIEW
Stewart J Tepper, Merrilee R Johnstone
There is a need for fast-acting, non-oral medication options for migraine because some attacks develop rapidly and some are accompanied by nausea, vomiting, and gastroparesis, which can hinder oral medication uptake and absorption. The most commonly prescribed migraine medications are oral triptans, with sumatriptan as the most common. However, oral triptans are associated with adverse events (AEs) of atypical sensations that may be problematic for patients. Subcutaneous (SC) injectable sumatriptan and conventional liquid triptan nasal spray formulations are also available, but the frequency of atypical sensations is the highest with SC sumatriptan, and the intense bitter taste of conventional liquid triptan nasal spray discourages use...
2018: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29760072/estrogen-receptor-%C3%AE-controls-proliferation-of-enteric-glia-and-differentiation-of-neurons-in-the-myenteric-plexus-after-damage
#5
F D'Errico, G Goverse, Y Dai, W Wu, M Stakenborg, E Labeeuw, V De Simone, B Verstockt, P J Gomez-Pinilla, M Warner, A Di Leo, G Matteoli, J A Gustafsson
Injury to the enteric nervous system (ENS) can cause several gastrointestinal (GI) disorders including achalasia, irritable bowel syndrome, and gastroparesis. Recently, a subpopulation of enteric glial cells with neuronal stem/progenitor properties (ENSCs) has been identified in the adult ENS. ENSCs have the ability of reconstituting the enteric neuronal pool after damage of the myenteric plexus. Since the estrogen receptor β (ERβ) is expressed in enteric glial cells and neurons, we investigated whether a selective ERβ agonist, LY3201, can influence neuronal and glial cell differentiation...
May 14, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29748143/the-investigation-and-treatment-of-diabetic-gastroparesis
#6
REVIEW
Mohit Kumar, Adam Chapman, Saad Javed, Uazman Alam, Rayaz A Malik, Shazli Azmi
PURPOSE: This review provides an update on the investigations and treatment options for gastroparesis. METHODS: A comprehensive literature search of Medline, PubMed, Embase and OVID was conducted which included all systematic reviews and research articles that focused on the diagnosis, investigations and management diabetic gastroparesis. FINDINGS: Dietary modifications and pharmacologic treatment with prokinetics to increase gastric motility form the mainstay of treatment...
May 7, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29745439/cannabinoids-and-gastrointestinal-motility-pharmacology-clinical-effects-and-potential-therapeutics-in-humans
#7
REVIEW
M Camilleri
BACKGROUND: Cannabinoid agents and cannabis are frequently used for relief of diverse gastrointestinal symptoms. PURPOSE: The objective of this article is to increase the awareness of gastroenterologists to the effects of cannabinoids on gastrointestinal motility, as gastroenterologists are likely to encounter patients who are taking cannabinoids, or those with dysmotility that may be associated with cannabinoid mechanisms. The non-selective cannabinoid agonist, dronabinol, retards gastric emptying and inhibits colonic tone and phasic pressure activity...
May 10, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29745434/efficacy-of-needleless-transcutaneous-electroacupuncture-in-synchronization-with-breathing-for-symptomatic-idiopathic-gastroparesis-a-blinded-and-controlled-acute-treatment-trial
#8
G Song, Y Sun, M Bashashati, A Quezada, S Sigaroodi, I Sarosiek, J D Z Chen, R W McCallum
BACKGROUND: Needleless transcutaneous electroacupuncture (TEA) improves nausea and myoelectrical activity in diabetic gastroparesis (GP). Synchronized TEA (STEA), which combines synchronized breathing with TEA, is more potent than TEA in enhancing vagal activity in healthy subjects. AIMS: To investigate whether STEA improves symptoms, electrogastrogram (EGG) and vagal activity in idiopathic gastroparesis (IGP). METHODS: Eighteen IGP subjects underwent 2 randomized visits (sham at non-acupoints or real STEA at acupoints) consisted of a 30-minute baseline, an Ensure challenge to provoke nausea, followed by 60-minute treatment with sham or real STEA, and 15-minute observation period...
May 10, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29735031/endoscopic-follow-up-of-intestinal-transplant-recipients
#9
REVIEW
Robert E Carroll
The growing population of intestinal transplant recipients present a unique challenge to the gastroenterologists responsible for their support and evaluation. Improvements in patient and graft survival are largely attributed to surgical advancements, refined antirejection therapy, and enhanced endoscopic surveillance protocols that better perceive rejection and other complications. This article reviews the endoscopic management and interventions provided for transplant recipients at the University of Illinois Hospital with complications, such as acute rejection, ischemia, bleeding, fistula, post-transplant lymphoproliferative disorder, and gastroparesis...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29722126/reproducibility-of-gastric-emptying-assessed-with-scintigraphy-in-patients-with-upper-gi-symptoms
#10
A Desai, M O'Connor, B Neja, K Delaney, M Camilleri, A R Zinsmeister, A E Bharucha
BACKGROUND: The reproducibility of gastric emptying (GE) measured with scintigraphy in patients is poorly understood. Our aims were to assess the intra and inter-individual reproducibility of these parameters in patients with upper gastrointestinal symptoms. METHODS: Sixty patients (21 diabetics, 39 non-diabetics) with upper gastrointestinal symptoms underwent scintigraphic-assessment of GE of a solid meal (296 kcal, 30% fat) over 4 hours on two occasions at an average interval of 15 days...
May 2, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29717525/a-single-center-audit-of-the-indications-and-clinical-impact-of-prolonged-ambulatory-small-intestinal-manometry
#11
D Ang, J Pannemans, T Vanuytsel, J Tack
BACKGROUND: Small bowel manometry is a diagnostic test available only in a few specialized referral centers. Its exact place in the management of refractory symptoms is controversial. METHODS: The records of all patients who underwent 24-hour ambulatory duodenojejunal manometry over a 6-year period were retrospectively reviewed. We studied the clinical indications for small bowel manometry, and reviewed the impact of manometric findings on the clinical outcome. One hundred and forty-six studies were performed in 137 patients (46M, 91F) with a mean age of 44...
May 1, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29713813/gastrointestinal-complications-after-lung-transplantation-in-japanese-patients
#12
Hidenao Kayawake, Toyofumi F Chen-Yoshikawa, Hideki Motoyama, Masatsugu Hamaji, Daisuke Nakajima, Akihiro Aoyama, Hiroshi Date
PURPOSE: Gastrointestinal complications after lung transplantation (LTx) are an important postoperative morbidity associated with malnutrition and the malabsorption of drugs. We reviewed our experience of managing gastrointestinal complications after LTx. METHODS: Between June, 2008 and April, 2017, 160 lung transplants were performed at our institution, as living-donor lobar lung transplants in 77 patients, and as deceased-donor lung transplants in 83. We reviewed, retrospectively, the incidence, type and management of gastrointestinal complications...
April 30, 2018: Surgery Today
https://www.readbyqxmd.com/read/29709494/pyloric-sphincter-characteristics-using-endoflip-%C3%A2-in-gastroparesis
#13
M Saadi, D Yu, Z Malik, H P Parkman, R Schey
INTRODUCTION AND AIMS: Pyloric sphincter abnormalities may be detected in gastroparesis. Botulinum toxin A (BoNT/A) injection into the pylorus has been used to treat gastroparesis with varying results. The aim of the present article was to assess whether pyloric sphincter characteristics using the endoscopic functional lumen imaging probe (EndoFLIP® ) with impedance planimetry in patients with gastroparesis correlated with symptoms, gastric emptying, and therapeutic response to pyloric sphincter BoNT/A injection...
April 27, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29687294/endoscopic-therapies-for-gastroparesis
#14
REVIEW
Andrew Su, Jeffrey L Conklin, Alireza Sedarat
PURPOSE OF REVIEW: Gastroparesis remains a difficult-to-treat disease with limited therapeutic options. Though patients often have a common syndrome of stereotypic symptoms, the underlying pathophysiology is heterogeneous, often leading to variable treatment responses. Due to limitations in medical and surgical therapies, endoscopic options have been increasingly explored. These options can be broadly categorized into pyloric-directed therapy, non-pyloric-directed therapy, and nutritional support...
April 23, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29672439/cajal-cell-counts-are-important-predictors-of-outcomes-in-drug-refractory-gastroparesis-patients-with-neurostimulation
#15
Endashaw Omer, Archana Kedar, Harsha S Nagarajarao, Yana Nikitina, Vetta Vedanarayanan, Charu Subramony, Christopher J Lahr, Thomas L Abell
BACKGROUND AND AIMS: Cajal cells serve as the pacemaker cells of the gastrointestinal tract and regulates peristalsis. On the baisis of that fact, it has been hypothesized that a decrease in Cajal cells can lead to gastroparesis and other motility issues. Treatment with medications has a limited efficacy and most resort to gastric electrical stimulation (GES) devices for symptomatic relief. We believe that the number of Cajal cells present is directly proportional to symptomatic relief with GES...
April 18, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29660525/gastric-peroral-endoscopic-pyloromyotomy-reduces-symptoms-increases-quality-of-life-and-reduces-healthcare-usage-for-patients-with-gastroparesis
#16
Parit Mekaroonkamol, Sunil Dacha, Lei Wang, Xiaoyu Li, Yueping Jiang, Lianyong Li, Tian Li, Nikrad Shahnavaz, Sonali Sakaria, Francis E LeVert, Steven Keilin, Field Willingham, Jennifer Christie, Qiang Cai
BACKGROUND AND AIMS: Gastric per-oral endoscopic pyloromyotomy (GPOEM) is becoming a promising treatment option for patients with refractory gastroparesis. We aimed to systematically assess the efficacy of GPOEM and its effects on healthcare usage. METHODS: We performed a retrospective study on 30 patients with refractory gastroparesis who underwent GPOEM from June 2015 through July 2017 at a tertiary center. We compared outcomes with those of 7 patients with refractory gastroparesis who did not undergo the procedure (controls)...
April 13, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29652893/glucose-sensor-augmented-continuous-subcutaneous-insulin-infusion-in-patients-with-diabetic-gastroparesis-an-open-label-pilot-prospective-study
#17
Jorge Calles-Escandón, Kenneth L Koch, William L Hasler, Mark L Van Natta, Pankaj J Pasricha, James Tonascia, Henry P Parkman, Frank Hamilton, William H Herman, Marina Basina, Bruce Buckingham, Karen Earle, Kjersti Kirkeby, Kristen Hairston, Tamis Bright, Amy E Rothberg, Andrew T Kraftson, Elias S Siraj, Angela Subauste, Linda A Lee, Thomas L Abell, Richard W McCallum, Irene Sarosiek, Linda Nguyen, Ronnie Fass, William J Snape, Ivana A Vaughn, Laura A Miriel, Gianrico Farrugia
Erratic blood glucose levels can be a cause and consequence of delayed gastric emptying in patients with diabetes. It is unknown if better glycemic control increases risks of hypoglycemia or improves hemoglobin A1c levels and gastrointestinal symptoms in diabetic gastroparesis. This study investigated the safety and potential efficacy of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) in poorly controlled diabetes with gastroparesis. Forty-five type 1 or 2 patients with diabetes and gastroparesis and hemoglobin A1c >8% from the NIDDK Gastroparesis Consortium enrolled in a 24 week open-label pilot prospective study of CSII plus CGM...
2018: PloS One
https://www.readbyqxmd.com/read/29649841/gastric-peroral-endoscopic-myotomy-for-the-treatment-of-refractory-gastroparesis-a-multicenter-international-experience
#18
Michel Kahaleh, Jean-Michel Gonzalez, Ming-Ming Xu, Iman Andalib, Monica Gaidhane, Amy Tyberg, Monica Saumoy, Alberto Jose Baptista Marchena, Marc Barthet
BACKGROUND:  Gastroparesis is a difficult-to-treat motility disorder with a poor response to medical therapy. Gastric peroral endoscopic pyloromyotomy (G-POEM) has been offered as a novel therapy in the treatment of refractory gastroparesis. We present a multicenter case series of our experience with G-POEM. METHODS:  This is an international multicenter case series of patients who underwent G-POEM for the treatment of gastroparesis. The severity of gastroparesis was assessed by delayed gastric emptying scintigraphy (GES) and an elevated gastroparesis cardinal symptoms index (GCSI)...
April 12, 2018: Endoscopy
https://www.readbyqxmd.com/read/29630025/direct-percutaneous-endoscopic-jejunostomy-for-the-management-of-gastroparesis-in-pregnancy
#19
Sawan Vijay Rupani, William F Ergen, Frederick Weber, Shajan Peter
BACKGROUND: Providing meaningful nutrition in cases of refractory hyperemesis during pregnancy can be challenging; although intragastric enteral nutrition is the most common approach, it is contraindicated in certain cases and carries the risk of increased nausea and vomiting. CASE: A 36-year-old primigravid woman with a history of gastroparesis presented at 16 weeks of gestation with nausea and vomiting. With no improvement with conventional approaches and signs of malnutrition, a direct percutaneous endoscopic jejunostomy was placed...
April 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29599809/electroacupuncture-at-st36-increases-bone-marrow-derived-interstitial-cells-of-cajal-via-the-sdf-1-cxcr4-and-mscf-kit-etv1-pathways-in-the-stomach-of-diabetic-mice
#20
Jiao Zhao, Jing An, Shi Liu
Background: The loss of interstitial cells of Cajal (ICC) is observed in diabetic gastroparesis. Electroacupuncture (EA) maintains ICC networks, but the effects and mechanisms of EA on ICC of bone marrow derivation in the stomach have not been investigated. Methods: C57BL/6 mice were randomized into six groups: control, diabetic (DM), bone marrow transplantation (BMT) + DM, BMT + DM + sham EA (SEA), BMT + DM + low-frequency EA (LEA), and BMT + DM + high-frequency (HEA)...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
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