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Gastroparesis: separate entity or just a part of dyspepsia?
  1. Vincenzo Stanghellini1,
  2. Jan Tack2,3
  1. 1Department of Digestive Diseases and Internal Medicine, University of Bologna, St Orsola-Malpighi Hospital, Bologna, Italy
  2. 2Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
  3. 3Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium
  1. Correspondence to Professor Vincenzo Stanghellini, Department of Digestive Diseases and Internal Medicine University of Bologna, St Orsola-Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy; v.stanghellini{at}unibo.it

Abstract

Gastroparesis is defined by the presence of delayed gastric emptying (GE) in the absence of mechanical obstruction. Symptoms that have been attributed to gastroparesis include postprandial fullness, early satiation nausea and vomiting. Gastroprokinetic drugs are the preferred treatment option. A number of problems with the concept of gastroparesis have been identified recently. Major overlap exists with the symptom complex of the functional dyspepsia subtype of postprandial distress syndrome. The distinguishing feature of gastroparesis is delayed GE, but the correlation between delayed emptying and symptom pattern or severity in gastroparesis is modest and the stability of delayed emptying over time is poor. Other pathophysiological mechanisms such as hypersensitivity or impaired accommodation may also underlie symptoms in patients with gastroparesis. Moreover, symptomatic response to prokinetic therapy is variable and cannot be predicted based on the degree of enhancing GE. A number of approaches have been proposed to increase clinical usefulness of a diagnosis of gastroparesis, including a higher threshold of abnormal emptying and selection of patients with a specific symptom pattern more likely to be associated with delayed emptying.

  • FUNCTIONAL DYSPEPSIA
  • GASTRIC EMPTYING
  • GASTROPARESIS
  • PROKINETIC AGENT

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