دورية أكاديمية
Reconsideration of the Gastroparetic Syndrome.
| العنوان: | Reconsideration of the Gastroparetic Syndrome. |
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| المؤلفون: | Gilbert RJ; Research Service, Providence VA Medical Center, Providence, RI, USA. rjgilbert12@gmail.com.; Department of Molecular Physiology, Pharmacology, and Biotechnology, Warren Alpert Medical School of Brown University, Providence, RI, USA. rjgilbert12@gmail.com.; Division of Gastroenterology and Departments of Medicine and Surgery, Brigham and Women's Hospital, Boston, MA, USA. rjgilbert12@gmail.com.; Ocean State Research Institute, Providence VA Medical Center, 830 Chalkstone Ave, Providence, RI, 02908, USA. rjgilbert12@gmail.com., Siamwala JH; Research Service, Providence VA Medical Center, Providence, RI, USA.; Department of Molecular Physiology, Pharmacology, and Biotechnology, Warren Alpert Medical School of Brown University, Providence, RI, USA.; Division of Gastroenterology and Departments of Medicine and Surgery, Brigham and Women's Hospital, Boston, MA, USA., Kumar V; Research Service, Providence VA Medical Center, Providence, RI, USA.; Department of Molecular Physiology, Pharmacology, and Biotechnology, Warren Alpert Medical School of Brown University, Providence, RI, USA.; Division of Gastroenterology and Departments of Medicine and Surgery, Brigham and Women's Hospital, Boston, MA, USA., Thompson CC; Research Service, Providence VA Medical Center, Providence, RI, USA.; Department of Molecular Physiology, Pharmacology, and Biotechnology, Warren Alpert Medical School of Brown University, Providence, RI, USA.; Division of Gastroenterology and Departments of Medicine and Surgery, Brigham and Women's Hospital, Boston, MA, USA., Shikora SA; Research Service, Providence VA Medical Center, Providence, RI, USA.; Department of Molecular Physiology, Pharmacology, and Biotechnology, Warren Alpert Medical School of Brown University, Providence, RI, USA.; Division of Gastroenterology and Departments of Medicine and Surgery, Brigham and Women's Hospital, Boston, MA, USA. |
| المصدر: | Current gastroenterology reports [Curr Gastroenterol Rep] 2023 Apr; Vol. 25 (4), pp. 75-90. Date of Electronic Publication: 2023 Apr 01. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Current Science Inc Country of Publication: United States NLM ID: 100888896 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-312X (Electronic) Linking ISSN: 15228037 NLM ISO Abbreviation: Curr Gastroenterol Rep Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia, PA : Current Science Inc., c1999- |
| مواضيع طبية MeSH: | Gastroparesis*/diagnosis , Gastroparesis*/etiology , Gastroparesis*/therapy, Humans ; Gastrointestinal Agents/therapeutic use ; Abdominal Pain ; Gastric Emptying/physiology |
| مستخلص: | Purpose of Review: Gastroparesis is a chronic disorder characterized by a constellation of foregut symptoms, including postprandial nausea, vomiting, distension, epigastric pain, and regurgitation in the absence of gastric outlet obstruction. Despite considerable research over the past decades, there remains to be only nominal understanding of disease classification, diagnostic criteria, pathogenesis, and preferred therapy. Recent Findings: We critically reassess current approaches for disease identification and stratification, theories of causation, and treatment for gastroparesis. Gastric scintigraphy, long considered a diagnostic standard, has been re-evaluated in light of evidence showing low sensitivity, whereas newer testing modalities are incompletely validated. Present concepts of pathogenesis do not provide a unified model linking biological impairments with clinical manifestations, whereas available pharmacological and anatomical treatments lack explicit selection criteria or evidence for sustained effectiveness. We propose a disease model that embodies the re-programming of distributed neuro-immune interactions in the gastric wall by inflammatory perturbants. These interactions, combined with effects on the foregut hormonal milieu and brain-gut axis, are postulated to generate the syndromic attributes characteristically linked with gastroparesis. Research linking models of immunopathogenesis with diagnostic and therapeutic paradigms will lead to reclassifications of gastroparesis that guide future trials and technological developments. Key Points: • The term gastroparesis embodies a heterogenous array of symptoms and clinical findings based on a complex assimilation of afferent and efferent mechanisms, gastrointestinal locations, and pathologies. • There currently exists no single test or group of tests with sufficient capacity to be termed a definitional standard for gastroparesis. • Present research regarding pathogenesis suggests the importance of immune regulation of intrinsic oscillatory activity involving myenteric nerves, interstitial cells of Cajal, and smooth muscle cells. • Prokinetic pharmaceuticals remain the mainstay of management, although novel treatments are being studied that are directed to alternative muscle/nerve receptors, electromodulation of the brain-gut axis, and anatomical (endoscopic, surgical) interventions. (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) |
| المشرفين على المادة: | 0 (Gastrointestinal Agents) |
| تواريخ الأحداث: | Date Created: 20230402 Date Completed: 20230417 Latest Revision: 20230417 |
| رمز التحديث: | 20230417 |
| DOI: | 10.1007/s11894-023-00865-w |
| PMID: | 37004633 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1534-312X |
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| DOI: | 10.1007/s11894-023-00865-w |