Help
Subscribe


Submit Videos to GastroHep 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: 108:1837
16 January 2013

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

 21 October 2014

Advanced search
 21 October 2014 
Alcohol and Barrett's
 21 October 2014 
Scoring systems for critically ill cirrhotic patients
 21 October 2014 
Aspirin and NAFLD
 20 October 2014 
Adalimumab in secondary loss of response in Crohn's
 20 October 2014 
Drug resistant H pylori eradication
 20 October 2014 
Omega-3 and colorectal cancer
 17 October 2014 
Tumor necrosis factor-alpha inhibitors and pregnancy in IBD
 17 October 2014 
Fecal microbiota composition in postinfectious IBS
 17 October 2014 
Colorectal testing utilization
 16 October 2014 
Risk of Barrett's esophagus
 16 October 2014 
Aspirin tablets and colorectal tumours
 16 October 2014 
Economic impact of IBS
 15 October 2014 
Achieving competency at colonoscopy
 15 October 2014 
Preparation for surgery in Crohn's
 15 October 2014 
Bowel preparations
 14 October 2014 
Colorectal testing utilization in commercially insured US adults
 14 October 2014 
Sustained response to infliximab
 14 October 2014 
IBD management during pregnancy
 13 October 2014 
Predicting PPI response in GERD-related cough
 13 October 2014 
Probiotics in IBS
 13 October 2014 
Use of azathioprine in IBD
 10 October 2014 
NAFLD in the Veterans Administration population
 10 October 2014 
Liver injury from herbals and dietary supplements
 10 October 2014 
Predictors for cecal insertion time
 09 October 2014 
Postoperative adhesions in digestive surgery
 09 October 2014 
Methotrexate-related liver disease and metabolic syndrome
 09 October 2014 
Biomarkers of acetaminophen overdose patients
 08 October 2014 
Gluten introduction in high risk children
 08 October 2014 
Vitamin D and HCC
 08 October 2014 
Feeding intervention in celiac disease infants
 07 October 2014 
Infliximab in pediatric perianal Crohn's
 07 October 2014 
Omega-3 and NAFLD
 07 October 2014 
Endoscopic submucosal dissection in the colorectum 
 06 October 2014 
Clinical indications for computed tomographic colonography
 06 October 2014 
Certolizumab pegol in the treatment of Crohn's
 06 October 2014 
Costs of telaprevir therapy for Hep C
 03 October 2014 
Depression and liver transplantation
 03 October 2014 
Orange juice intake during bowel preparation
 03 October 2014 
HCV and diabetes
 02 October 2014 
Predictive model of Hep C disease progression
 02 October 2014 
IPAA with or without preoperative radiation
 02 October 2014 
Person-to-person transmission of norovirus
 01 October 2014 
Prevention of postop Crohn's
 01 October 2014 
Cecal intubation time during colonoscopy
 01 October 2014 
Anti-TNFa therapies during pregnancy in IBD
 30 September 2014 
Autoimmune hepatitis
 30 September 2014 
Medication use in patients with chronic Hep C
 30 September 2014 
Gastric cancer according to H pylori infection status
 29 September 2014 
Drug exposure and microscopic colitis
 29 September 2014 
Peptic ulcer bleeding after PPI treatment
 29 September 2014 
Intestinal tuberculosis vs Crohn's disease
 26 September 2014 
5-aminosalicylates for the treatment of Crohn's
 26 September 2014 
Response to infliximab in paediatric perianal Crohn's
 26 September 2014 
Ondansetron for IBS with diarrhea
 25 September 2014 
Medical treatment and surgery rates in IBD
 25 September 2014 
Liver transplants for liver cancer
 25 September 2014 
Colorectal neoplasia among family members of patients with colorectal cancer
 24 September 2014 
Health services burden of IBD
 24 September 2014 
PPIs after antireflux surgery
 24 September 2014 
Antidepressants in chronic liver disease

Blackwell Publishing


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