Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Management of gastroparesis

This month's American Journal of Gastroenterology presents recommendations for the evaluation and management of patients with gastroparesis.

News image

Dr Michael Camilleri and colleagues from Minnesota, USA present recommendations for the evaluation and management of patients with gastroparesis.

Gastroparesis is identified in clinical practice through the recognition of the clinical symptoms and documentation of delayed gastric emptying.

Symptoms from gastroparesis include nausea, vomiting, early satiety, postprandial fullness, bloating, and upper abdominal pain.

Management of gastroparesis should include assessment and correction of nutritional state, relief of symptoms, improvement of gastric emptying and, in diabetics, glycemic control.

The researh team reported that a patient's nutritional state should be managed by oral dietary modifications.

If oral intake is not adequate, then enteral nutrition via jejunostomy tube needs to be considered.

The doctors noted that parenteral nutrition is rarely required when hydration and nutritional state cannot be maintained.

Second-line approaches include venting gastrostomy
American Journal of Gastroenterology

Medical treatment entails use of prokinetic and antiemetic therapies.

The team found that currently approved treatment options, including metoclopramide and gastric electrical stimulation, do not adequately address clinical need.

The team of researchers discovered that antiemetics have not been specifically tested in gastroparesis, but they may relieve nausea and vomiting.

Other medications aimed at symptom relief include unapproved medications or off-label indications, and include domperidone, erythromycin, and centrally acting antidepressants used as symptom modulators.

The team of doctors found that gastric electrical stimulation may relieve symptoms, including weekly vomiting frequency, and the need for nutritional supplementation, based on open-label studies.

Second-line approaches include venting gastrostomy or feeding jejunostomy.

Intrapyloric botulinum toxin injection was not effective in randomized controlled trials.

Dr Camilleri's team concludes, "Most of these treatments are based on open-label treatment trials and small numbers."

"Partial gastrectomy and pyloroplasty should be used rarely, only in carefully selected patients."

"Attention should be given to the development of new effective therapies for symptomatic control." 

Am J Gastroenterol 2013: 108:18–37
16 January 2013

Go to top of page Email this page Email this page to a colleague

 23 August 2014

Advanced search
 22 August 2014 
Endoscopic submucosal dissection for squamous esophageal cancer
 22 August 2014 
Adherence to Rome criteria in functional dyspepsia trials
 22 August 2014 
Outlier identification in colorectal surgery
 21 August 2014 
Screening for Barrett’s esophagus
 21 August 2014 
Colorectal cancer mortality in Brazil
 21 August 2014 
Eosinophilic esophagitis
 20 August 2014 
Rectal surgery mortality
 20 August 2014 
Chemotherapy-induced gastrointestinal mucositis
 20 August 2014 
Stool methylated DNA markers and colorectal cancer resection
 19 August 2014 
Recurrent C. difficile infection in out-patients
 19 August 2014 
Racial disparities and colon cancer
 19 August 2014 
Variability of colonoscopy preparation instructions
 18 August 2014 
The evolution of urban C. difficile
 18 August 2014 
Metabolomic analysis in IBD
 18 August 2014 
Enhanced T-cell response in acute-on-chronic Hep B
 15 August 2014 
Abdominal pain in IBS
 15 August 2014 
Gene expression biomarker in ulcerative colitis
 15 August 2014 
Population-based fecal immunochemical test screening
 14 August 2014 
Transnasal vs transoral endoscopy
 14 August 2014 
Radiation exposure in gastroenterology
 14 August 2014 
Dietary fibre and diverticular disease
 13 August 2014 
Flexible sigmoidoscopy screening
 13 August 2014 
Adherence to Rome criteria in functional dyspepsia
 13 August 2014 
Fecal immunochemical test screening
 12 August 2014 
Eosinophilic esophagitis and celiac disease
 12 August 2014 
Management of Lynch syndrome
 12 August 2014 
Risk of cancer under immunosuppressive therapy in IBD
 11 August 2014 
Risk of GI bleeds with anticoagulants
 11 August 2014 
Social media in health-care
 11 August 2014 
Gut microbiota in chemotherapy-induced GI mucositis
 08 August 2014 
Endoscopy nurse-administered propofol sedation performance
 08 August 2014 
Therapy for biliary tract cancer
 08 August 2014 
Surgeon volume and esophagectomy survival
 07 August 2014 
Global consensus on perianal fistulizing Crohn's disease
 07 August 2014 
Smoking cessation and age of onset of ulcerative colitis
 07 August 2014 
Colonoscopy length and training duration
 06 August 2014 
Hepatitis C virus infection in the United States
 06 August 2014 
Pediatric to adult IBD care
 06 August 2014 
Biomarker of disease activity in IBD
 05 August 2014 
Rising incidence of celiac disease
 05 August 2014 
Socioeconomic status and IBS
 05 August 2014 
Bowel dysfunction after sphincter-preserving rectal cancer surgery
 04 August 2014 
Relative adrenal insufficiency and chronic liver disease
 04 August 2014 
Colonoscopy screening protocol for liver transplant recipients
 04 August 2014 
Patient-reported outcomes after upper GI bleed
 01 August 2014 
Capsule colonoscopy vs CT colonography for polyp screening
 01 August 2014 
Complications after obesity surgery
 01 August 2014 
Fully covered self-expanding metal stents for benign biliary strictures
 31 July 2014 
Biomarkers in liver fibrosis
 31 July 2014 
Risk factors of large colorectal polyps
 31 July 2014 
Diverticular disease and colon cancer
 30 July 2014 
Small intestinal permeability in diarrhea predominant IBS
 30 July 2014 
Mineral rich water and constipation
 30 July 2014 
Interval between screening colonoscopies
 29 July 2014 
Fluticasone in eosinophilic esophagitis
 29 July 2014 
Causes of GI bleeding in cirrhosis
 29 July 2014 
ALT increases in Hep B
 28 July 2014 
Statins reduce Barrett's
 28 July 2014 
Score predicts risk for Barrett’s esophagus
 28 July 2014 
Gastric cancer prevention

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us