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Diabetic gastroparesis

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https://www.readbyqxmd.com/read/28918793/-workup-and-treatment-of-gastroparesis
#1
Mette Winther Klinge, Jan Bech Pedersen, Birgit Schelde, Sten Lund, Klaus Krogh
Gastroparesis is defined as impaired gastric emptying without mechanical obstruction and cardinal symptoms including vomiting, nausea, early satiety, and upper abdominal pain. Most cases of gastroparesis are diabetic, idiopathic or post-operative. The correlation between symptoms and objective measures of gastroparesis is poor. Basic treatment includes dietary advices and prokinetics. Selected patients not responding to basic treatment can be offered gastric electrical stimulation. In many cases, gastroparesis is present in combination with other motility disorders, especially constipation...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28913777/diabetes-and-the-small-intestine
#2
REVIEW
Jonathan Gotfried, Stephen Priest, Ron Schey
Diabetes mellitus (DM) and its associated complications are becoming increasingly prevalent. Gastrointestinal symptoms associated with diabetes is known as diabetic enteropathy (DE) and may manifest as either diarrhea, fecal incontinence, constipation, dyspepsia, nausea, and vomiting or a combination of symptoms. The long-held belief that vagal autonomic neuropathy is the primary cause of DE has recently been challenged by newer theories of disease development. Specifically, hyperglycemia and the resulting oxidative stress on neural networks, including the nitrergic neurons and interstitial cells of Cajal (ICC), are now believed to play a central role in the development of DE...
September 15, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28913607/diabetes-and-the-esophagus
#3
REVIEW
Roberto Monreal-Robles, José M Remes-Troche
Chronic hyperglycemia is a well-known cause of gastrointestinal motility disorders extending from the esophagus to the anorectum. Even though little attention has been paid to esophageal disorders in the context of DM, its prevalence is higher compared to gastroparesis. Heartburn, as a typical symptom of gastroesophageal reflux disease (GERD), is the most prevalent symptom and has been found in 25 to 41% of patients with DM. Furthermore, DM has recently been established as possible independent factor for the development of Barrett's esophagus...
September 15, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28888796/laparoscopic-treatment-of-gastroparesis-a-single-center-experience
#4
Kotaro Wakamatsu, Federico Perez Quirante, Lisandro Montorfano, Emanuele Lo Menzo, Yasuyuki Seto, Raul J Rosenthal
BACKGROUND: Gastroparesis (GP) is a chronic disorder of gastric motility with delayed gastric emptying. Gastric electrical stimulator (GES) implantation and Roux-en-Y gastric bypass (RYGB) are surgical options for medically refractory GP. OBJECTIVE: Evaluate operational outcomes and symptom improvement of patients with diabetic (DM) and idiopathic (IP) GP. SETTING: University Hospital, United States. METHODS: A retrospective chart review was performed of all patients who underwent surgical treatment of GP from February 2003 to December 2014...
July 29, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28879488/diabetes-and-the-stomach
#5
REVIEW
Allen A Lee, William L Hasler
Longstanding diabetes mellitus (both type 1 and type 2) can impair gastric motor function and cause significant upper gastrointestinal symptoms which significantly degrade quality of life, cause nutritional deficits, and degrade healthcare resource use. The most commonly considered gut complication of diabetes, diabetic gastroparesis, is a syndrome of delayed gastric emptying in the absence of mechanical obstruction which leads to symptoms of nausea, vomiting, postprandial fullness, early satiation, bloating, and upper abdominal pain...
September 6, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28872760/relating-gastric-scintigraphy-and-symptoms-to-motility-capsule-transit-and-pressure-findings-in-suspected-gastroparesis
#6
W L Hasler, K P May, L A Wilson, M Van Natta, H P Parkman, P J Pasricha, K L Koch, T L Abell, R W McCallum, L A Nguyen, W J Snape, I Sarosiek, J O Clarke, G Farrugia, J Calles-Escandon, M Grover, J Tonascia, L A Lee, L Miriel, F A Hamilton
BACKGROUND: Wireless motility capsule (WMC) findings are incompletely defined in suspected gastroparesis. We aimed to characterize regional WMC transit and contractility in relation to scintigraphy, etiology, and symptoms in patients undergoing gastric emptying testing. METHODS: A total of 209 patients with gastroparesis symptoms at NIDDK Gastroparesis Consortium centers underwent gastric scintigraphy and WMCs on separate days to measure regional transit and contractility...
September 5, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28760384/efficacy-and-safety-of-relamorelin-in-diabetics-with-symptoms-of-gastroparesis-a-randomized-placebo-controlled-study
#7
Michael Camilleri, Richard W McCallum, Jan Tack, Sharon C Spence, Keith Gottesdiener, Fred T Fiedorek
BACKGROUND & AIMS: Gastroparesis is a complication of diabetes with few treatment options. Relamorelin (also called RM-131) is a selective, prokinetic agonist of ghrelin. We aimed to evaluate efficacy of relamorelin on symptoms and gastric emptying (GE) in a 12-week, phase 2B study of diabetic patients with moderate to severe gastroparesis symptoms (DG). METHODS: We performed a study of 393 patients with DG (37.7% male; 9.9% with type 1 diabetes; median age, 58...
July 28, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28721575/gastroparesis-medical-and-therapeutic-advances
#8
REVIEW
Christopher M Navas, Nihal K Patel, Brian E Lacy
Gastroparesis is a chronic, bothersome, and often disabling neuromuscular disorder of the upper gastrointestinal tract. The most frequently reported symptoms of gastroparesis include nausea, vomiting, epigastric pain, early satiety, and unintentional weight loss. Etiologies of gastroparesis include diabetes, connective tissue disorders, prior infection, mesenteric ischemia, and post-surgical complications. The largest category of gastroparesis patients is comprised of those in whom no definitive cause can be identified (idiopathic gastroparesis)...
July 18, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28697124/effect-of-intravenous-fluids-and-analgesia-on-dysmotility-in-patients-with-acute-pancreatitis-a-prospective-cohort-study
#9
Landy M Wu, Sayali A Pendharkar, Varsha M Asrani, John A Windsor, Maxim S Petrov
OBJECTIVES: Analgesia and intravenous fluid resuscitation are cornerstones of initial patient management in acute pancreatitis (AP). The aim was to investigate the effect of intravenous fluids and analgesia on gastrointestinal motility in the early course of AP. METHODS: Gastrointestinal dysmotility was assessed using the Gastroparesis Cardinal Symptom Index (GCSI). One-way analysis of variance and analysis of covariance were conducted, adjusting for age, sex, body mass index, severity of AP, preexisting diabetes mellitus, and time from first symptom onset to hospital admission...
August 2017: Pancreas
https://www.readbyqxmd.com/read/28639130/vitamin-c-improves-gastroparesis-in-diabetic-rats-effects-on-gastric-contractile-responses-and-oxidative-stress
#10
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
#11
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
#12
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...
August 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28567693/per-oral-endoscopic-pyloromyotomy-for-refractory-gastroparesis-initial-results-from-a-single-institution
#13
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/28504312/g-poem-with-antro-pyloromyotomy-for-the-treatment-of-refractory-gastroparesis-mid-term-follow-up-and-factors-predicting-outcome
#14
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/28438610/hyperglycemia-increases-interstitial-cells-of-cajal-via-mapk1-and-mapk3-signaling-to-etv1-and-kit-leading-to-rapid-gastric-emptying
#15
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...
August 2017: Gastroenterology
https://www.readbyqxmd.com/read/28413522/electroacupuncture-combined-with-mosapride-alleviates-symptoms-in-diabetic-patients-with-gastroparesis
#16
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/28374487/gastric-neuromuscular-histology-in-patients-with-refractory-gastroparesis-relationships-to-etiology-gastric-emptying-and-response-to-gastric-electric-stimulation
#17
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/28336106/nomogram-for-predicting-oral-feeding-intolerance-in-patients-with-acute-pancreatitis
#18
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/28320545/haloperidol-undermining-gastroparesis-symptoms-hugs-in-the-emergency-department
#19
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...
August 2017: American Journal of Emergency Medicine
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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