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

 27 February 2015

Advanced search
 27 February 2015 
Obesity and weight-loss therapy
 27 February 2015 
MRE performance in staging liver fibrosis
 27 February 2015 
Bleeding in diverticulosis
 26 February 2015 
Familial colorectal cancer risk and primary cancer
 26 February 2015 
Questionnaires for GERD
 26 February 2015 
Herbal products and the liver
 25 February 2015 
Exercise and NAFLD
 25 February 2015 
IBD in Korea
 25 February 2015 
Immunosuppressive therapy and T. whipplei
 24 February 2015 
Clinical trials in pediatric IBD
 24 February 2015 
Reducing health care costs in IBD
 24 February 2015 
GI bleeding after anticoagulation interruption
 23 February 2015 
Visceral abdominal obesity and IBS
 23 February 2015 
Crohn's outcomes with infliximab
 23 February 2015 
Intestinal microbiota and celiac disease
 20 February 2015 
H. pylori eradication
 20 February 2015 
Antiviral treatment and Hep C outcomes
 20 February 2015 
C. diff testing in IBD
 19 February 2015 
Intestinal microbiota in IBS
 19 February 2015 
Peptic ulcer bleeding mortality in liver disease
 19 February 2015 
Fecal microbial transplant in active Crohn's disease
 18 February 2015 
Genetic testing and GI cancers
 18 February 2015 
Placebo analgesia in functional abdominal pain
 18 February 2015 
Successful Hep C virus therapy
 17 February 2015 
Quality measures and colonoscopist selection
 17 February 2015 
Global incidence of esophageal cancer
 17 February 2015 
Anti-viral treatment and survival in Hep C
 16 February 2015 
Saliva for the diagnosis of GERD
 16 February 2015 
H pylori eradication therapy
 16 February 2015 
Medical marijuana for digestive disorders
 13 February 2015 
Beta-blockers in cirrhosis
 13 February 2015 
Liver disease and peptic ulcer bleeding
 13 February 2015 
Prevalence of microscopic colitis
 12 February 2015 
Liver disease in chronic Hep C
 12 February 2015 
Patient-reported outcomes in Hep C
 12 February 2015 
Patients’ colonoscopist selection
 11 February 2015 
NAFLD and CVD
 11 February 2015 
Guidelines for the diagnosis of hepatocellular carcinoma
 11 February 2015 
Hepatic decompensation in Hep C cirrhosis
 10 February 2015 
Percutaneous endoscopic gastrostomy
 10 February 2015 
Factors that influence hepatic steatosis
 10 February 2015 
Gene variants and Crohn's susceptibility
 09 February 2015 
Factors that influence gallstone surgery
 09 February 2015 
Factors associated with increased mortality in cirrhosis
 09 February 2015 
Use of immunomodulators in IBD
 06 February 2015 
Colorectal cancer risk in IBD
 06 February 2015 
H. pylori and peptic ulcer bleeding
 06 February 2015 
IBS and somatization
 05 February 2015 
GERD, dyspepsia and IBS symptoms
 05 February 2015 
Quality of life in Crohn's after antitumor necrosis factor agents
 05 February 2015 
Thalidomide and refractory Crohn's
 04 February 2015 
Telemedicine in IBD
 04 February 2015 
Infliximab and muscle wasting in Crohn's
 04 February 2015 
Resistance mutations in chronic Hep B
 03 February 2015 
Testosterone in advanced liver disease
 03 February 2015 
Mortality in peptic ulcer bleeding
 03 February 2015 
Colonoscopic remission of ulcerative colitis
 02 February 2015 
Colonoscopy and colon cancer risk in IBD
 02 February 2015 
Sirolimus in Hep C virus infected liver graft recipients
 02 February 2015 
Treatment of C. diff in adults

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us