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Your search term(s) "gastroparesis" returned 25 results.
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Gastrointestinal Motility Disorders. IN: Hauser, S., ed. Mayo Clinic Gastroenterology and Hepatology Board Review. 3rd ed. New York, NY: Informa Healthcare USA. 2008. pp 97-110.
This chapter on gastrointestinal (GI) motility disorders is from a comprehensive textbook that provides an in-depth examination of essential knowledge in gastroenterology, hepatology, and the related areas of pathology, endoscopy, nutrition, and radiology. The authors note that motility disorders result from impaired control of the neuromuscular apparatus of the gut. Associated symptoms include recurrent or chronic nausea, vomiting, bloating and abdominal discomfort, constipation, or diarrhea, which occur in the absence of intestinal obstruction. The chapter covers control of GI motor function, gastric and small-bowel motility, the pathogenesis of motility disorders, the management of gastroparesis and pseudo-obstruction, and treatment strategies, including the correction of hydration and nutritional deficiencies, medications, decompression, surgical treatment, and new therapies. An additional section considers functional dyspepsia. The authors conclude that understanding the mechanisms that control motility and the pathophysiologic mechanisms is the key to optimal management. Simple, quantitative measures of transit and an algorithmic approach to identifying the underlying cause may lead to correction of abnormal function. Patient education is essential to avoid aggravation of symptoms caused by dietary indiscretions. The chapter is illustrated with full-color drawings and photographs. 4 figures. 3 tables. 19 references.
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Diabetic Gastroparesis. New England Journal of Medicine. 356(8): 820-829. February 22, 2007.
This article on diabetic gastroparesis begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies of diagnosis and therapy is then presented, followed by a review of formal guidelines. The article ends with the author's clinical recommendations. This case study features a 36-year-old man with a 20-year history of type 1 diabetes mellitus, background retinopathy, peripheral sensory neuropathy, and nephropathy who presents with a history of several months of nausea and vomiting of undigested food and bile, during which time he lost 4 kilograms. Topics covered include normal gastric emptying, the syndrome of gastroparesis-impaired gastric emptying—in patients with diabetes, diagnostic strategies, drug therapy, nutritional support, surgery, nondrug therapy, and areas of uncertainty. Key principles in the management of diabetic gastroparesis are the correction of exacerbating factors, including optimization of glucose and electrolyte levels; the provision of nutritional support; and the use of prokinetic and symptomatic therapies. 2 figures. 2 tables. 53 references.
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Diabetic Neuropathy. IN: Beaser, R.S., ed. Joslin’s Diabetes Deskbook: A Guide For Primary Care Providers. 2nd ed. Boston, MA: Joslin Diabetes Center. 2007. pp 481-504.
This chapter on diabetic neuropathy is from a book that gives primary care providers a comprehensive overview of diabetes care. The author notes that the diabetic neuropathies include several distinctive syndromes with different clinical symptoms, anatomic distributions, clinical course, and pathophysiology. The chapter begins with a discussion of the classification of diabetic neuropathies, then covers the epidemiology, clinical features, and pathogenesis of generalized polyneuropathy; the impact of autonomic neuropathy on the cardiovascular, urogenital, gastrointestinal, and sudomotor systems; acute painful neuropathy; hyperglycemic neuropathy; chronic inflammatory demyelinating polyneuropathy; treatment-induced neuropathy; and focal and multifocal neuropathies, including cranial neuropathy, proximal motor neuropathy, thoracic radiculopathy, and limb mononeuropathy. The next section reviews the evaluation of diabetic peripheral neuropathy, including the clinical examination, electromyogram and nerve conduction studies, quantitative sensory testing, and autonomic function testing such as cardiac vagal function, evaluation of sympathetic adrenergic function, and tests of sympathetic cholinergic function. A final section considers treatment options for peripheral neuropathy, including hyperglycemia; autonomic dysfunction such as orthostatic hypotension, gastroparesis diabeticorum, and erectile dysfunction (ED); and painful neuropathy, which can be treated with tricyclic and other antidepressants, anticonvulsants, antiarrhythmias, topical agents, and typical and atypical opioids. The author concludes that neuropathies can be significant contributors to the morbidity and mortality associated with diabetes and can have a severe impact on the patient’s quality of life. 3 tables.
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Gastrointestinal Electrical Stimulation for Treatment of Gastrointestinal Disorders: Gastroparesis, Obesity, Fecal Incontinence, And Constipation. Gastroenterology Clinics of North America. 36(3): 713-734. September 2007.
This article on the use of electrical stimulation to treat gastroparesis, obesity, fecal incontinence, and constipation is from a special issue of Gastroenterology Clinics of North America that focuses on gastrointestinal (GI) motility. The authors note that because these organs have their own natural pacemakers the electrical signals they generate can be altered by externally delivering electric currents by intramuscular, serosal, or intraluminal electrodes to specific sites in the GI tract. They describe various methods of GI electrical stimulation and their peripheral and central effects and mechanisms; update the status of GI electrical stimulation in the clinical settings of gastroparesis, obesity, fecal incontinence, and constipation; and predict future directions and developments of GI electrical stimulation technology and their areas of possible clinical applications. The authors conclude that, although some of the research results are still equivocal, most studies indicate that electrical stimulation is able to alter certain GI functions. 9 figures. 1 table. 123 references.
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Gastrointestinal Motility Disorders. Gastroenterology Clinics of North America. 36(3): 1-774. September 2007.
This issue of Gastroenterology Clinics of North America focuses on gastrointestinal (GI) motility disorders. The issue includes 14 articles: the classification, prevalence, and epidemiology of GI motility and functional GI disorders; neurogastroenterology and enteric sciences; evolving concepts in the cellular control of GI motility; laboratory tests used to evaluate GI motility; new technologies used for evaluation of esophageal motility disorders, including impedance, high-resolution manometry, and intraluminal ultrasound; the presentation, evaluation, and treatment of esophageal motor and sensory disorders; the presentation, evaluation, and treatment of the different manifestations of gastroesophageal reflux disease (GERD); the gastroesophageal antireflux barrier; the symptoms, evaluation, and treatment of gastroparesis; the mechanisms of symptom generation and appropriate management of patients with functional dyspepsia; the symptoms, evaluation, and treatment of irritable bowel syndrome; the evaluation and treatment of colonic and anorectal motility disorders, including constipation; the use of GI electrical stimulation for the treatment of GI disorders, including gastroparesis, obesity, fecal incontinence, and constipation; the role of bacteria in GI motility disorders; and GI motility disorders in adolescent patients, including the transition to adult health care settings. Some articles include full-color illustrations and all conclude with a list of references for further reading. A subject index concludes the issue.
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Gastrointestinal Syndromes Due to Diabetes Mellitus. IN: Veves, A.; Malik, R.A., eds. Diabetic Neuropathy: Clinical Management. 2nd ed. Totowa, NJ: Humana Press. 2007. pp 433-452.
This chapter on gastrointestinal (GI) symptoms due to diabetes mellitus is from a comprehensive textbook that provides general practitioners details on the latest techniques for the clinical management of diabetic neuropathy. The author cautions that disturbances may manifest as symptoms and metabolic changes that can, in turn, impinge in the management of the patient with diabetes. Diet therapy is an important component of diabetes management for all people with diabetes. The author describes the pathophysiology, clinical findings, and management options for dealing with the main clinical syndromes associated with disturbances of GI physiology in people with diabetes. These disturbances include esophageal dysfunction, gastroparesis, diarrhea, constipation, fecal incontinence, and irritable bowel syndrome (IBS). The author provides advice about indications and interpretations of various diagnostic tests used to confirm these conditions. Treatment strategies are outlined and reviewed. 4 figures. 3 tables. 95 references.
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Gastrointestinal Syndromes Due to Diabetes Mellitus. IN: Veves, A.; Malik, R.A., eds. Diabetic Neuropathy: Clinical Management. 2nd ed. Totowa, NJ: Humana Press. 2007. pp 433-452.
This chapter on gastrointestinal syndromes due to diabetes mellitus is from a textbook on diabetic neuropathy. The author describes the pathophysiology, clinical findings, and management options for dealing with the main clinical syndromes associated with disturbances of gastrointestinal (GI) physiology in people with diabetes. Specific topics include esophageal dysfunction, which can be a source of bothersome upper GI symptoms, and gastroparesis, the most characteristic form of gastroduodenal dysfunction associated with diabetes. Other GI problems considered include diarrhea, irritable bowel syndrome, constipation, and fecal incontinence. The author provides advice about indications and interpretation of various diagnostic tests and reviews the more common drugs now available or expected in the future that can be used for these various clinical problems. The author notes that, from a pathophysiological perspective, alterations in gut motor, secretory, and absorptive functions may be observed in diabetes. In addition, abnormal function, that is, motility, might affect predominantly one region of the gut, manifesting itself clinically as a regional disorder. However, additional diagnostic testing may reveal the problem as involving multiple regions of the gut. 4 figures. 3 tables. 95 references.
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Pharmacological Management of Chronic Gastroparesis. Practical Gastroenterology. 31(6): 44-59. June 2007.
Gastroparesis is a symptomatic, chronic disorder characterized by delayed gastric emptying in the absence of mechanical gastric outlet problems or intestinal obstruction. This article provides practicing gastroenterologists and other professionals a broad-based review of the drug therapy available for the medical management of patients with chronic gastroparesis. The authors support the aggressive combination treatments involving antiemetics, prokinetics, and analgesics. When medical therapy is not able to sustain symptom relief and quality of life, gastric electrical stimulation is a new option for these patients. The authors note that advances in understanding the mechanisms associated with chronic nausea and vomiting, as well as gastric stasis, have set the stage for better therapies that reflect the underlying pathophysiology. Guidelines are provided to help clinicians achieve symptomatic control of this very challenging clinical entity. A patient care algorithm is provided. 2 figures. 41 references.
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Complications of Long-Term Parenteral Nutrition. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 461-474.
This chapter about the complications of long-term parenteral nutrition (PN) is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the gastrointestinal (GI) tract. This chapter covers survival and prognosis; catheter-related complications, including infections, catheter sepsis, exit-site and tunnel infections, and catheter occlusions; renal complications; GI complications, including gastroparesis and intestinal hypoplasia; metabolic bone disease; hepatic disease, including liver test abnormalities and morphological changes, possible etiologies, and potential therapies; and biliary disease. The author concludes that both survival and morbidity are significantly affected by potentially serious complications related to the use of long-term PN. Infectious complications, the most common, are often related to insufficient patient or caregiver education, which results in suboptimal catheter care. 5 figures. 2 tables. 222 references.
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Gastroparesis. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 6 p.
This fact sheet describes gastroparesis, also called delayed gastric emptying, a disorder in which the stomach takes too long to empty its contents. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract. Written in a question-and-answer format, the fact sheet covers the causes of gastroparesis, symptoms, the complications of the condition, diagnostic tests used to confirm gastroparesis, treatment options, and caring for patients with diabetes and gastroparesis. Treatment strategies outlined include medications such as metoclopramide, erythromycin, and domperidone; dietary changes; the use of a feeding tube; parenteral nutrition; gastric electrical stimulation; and botulinum toxin. The most common cause of gastroparesis is diabetes; the primary treatment goals for gastroparesis related to diabetes are to improve stomach emptying and regain control of blood glucose levels. Patients with diabetes and gastroparesis usually undertake changes such as six smaller meals and increased use of insulin. The fact sheet concludes with a brief section on current research efforts in this area, a summary of the important points covered in the fact sheet, a list of organizations that can provide readers with more information, and a description of the goals and activities of the National Digestive Diseases Information Clearinghouse (NDDIC). 1 figure.
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