المؤلفون: Sarosiek, Irene, Van Natta, Mark, Parkman, Henry P., Abell, Thomas, Koch, Kenneth L., Kuo, Braden, Shulman, Robert J., Farrugia, Gianrico, Grover, Madhusudan, Hamilton, Frank A., Pasricha, Pankaj J., Yates, Katherine P., Miriel, Laura, Wilson, Laura, Yamada, Goro, Tonascia, James, McCallum, Richard W.

المصدر: Clinical Gastroenterology & Hepatology; Mar2022, Vol. 20 Issue 3, pe452-e464, 13p

مستخلص: The use of domperidone (DOM) for gastroparesis (GP) remains controversial and limited. We aimed to present outcomes of DOM therapy for treatment of patients participating in the multicenter National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium (GpCRC) Registries (GpR). The GpCRC cohort consisted of patients with GP (75%) and with GP-like symptoms but with normal gastric emptying (25%). The DOM group initiated therapy during the 96 weeks of enrollment in GpR1 and GpR2. Patients who had previously taken or who were on DOM therapy at enrollment were excluded from this analysis. The control group did not use domperidone (non-DOM group) before or after enrollment. The following outcome measures were identified: change from baseline in Gastroparesis Cardinal Symptom Index total score, with 3 subscales, plus Gastroesophageal Reflux Disease and Patient Assessment of Upper Gastrointestinal Disorders–Quality of Life scores. Overall, of 748 patients, 181 (24%) were in the DOM group, whereas 567 were in the non-DOM group. Sixty-three percent of participants had idiopathic GP. At baseline, DOM patients compared with non-DOM patients were significantly younger, had lower body mass index, non-Hispanic ethnicity, a higher annual household income, lower narcotic utilization, lower supplemental and complimentary medication use, and were more likely to have delayed gastric emptying time, as well as worse nausea and fullness scores. Compared with non-DOM patients, DOM patients experienced moderate but significantly more improvement in GP outcome measures: Gastroparesis Cardinal Symptom Index total score (P =.003), nausea (P =.003), and fullness subscales (P =.005), upper abdominal pain score (P =.04), Gastroesophageal Reflux Disease score (P =.05), and Patient Assessment of Upper Gastrointestinal Disorders–Quality of Life score (P =.05). Utilizing the method of pragmatic modeling to evaluate long-term treatment of GP in a large GpCRC database, DOM treatment resulted in moderately but significantly improved GP. This project was based on data generated by 2 GpCRC Registry studies recognized under the Clinicaltrial.gov numbers: NCT00398801 and NCT01696747 symptoms compared with a group receiving standard-of-care but not DOM. [ABSTRACT FROM AUTHOR]

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المؤلفون: Pasricha, Pankaj J., Grover, Madhusudan, Yates, Katherine P., Abell, Thomas L., Bernard, Cheryl E., Koch, Kenneth L., McCallum, Richard W., Sarosiek, Irene, Kuo, Braden, Bulat, Robert, Chen, Jiande, Shulman, Robert J., Lee, Linda, Tonascia, James, Miriel, Laura A., Hamilton, Frank, Farrugia, Gianrico, Parkman, Henry P.

المصدر: Gastroenterology (00165085); May2021, Vol. 160 Issue 6, p2006-2017, 12p

مستخلص: The aim of this study was to clarify the pathophysiology of functional dyspepsia (FD), a highly prevalent gastrointestinal syndrome, and its relationship with the better-understood syndrome of gastroparesis. Adult patients with chronic upper gastrointestinal symptoms were followed up prospectively for 48 weeks in multi-center registry studies. Patients were classified as having gastroparesis if gastric emptying was delayed; if not, they were labeled as having FD if they met Rome III criteria. Study analysis was conducted using analysis of covariance and regression models. Of 944 patients enrolled during a 12-year period, 720 (76%) were in the gastroparesis group and 224 (24%) in the FD group. Baseline clinical characteristics and severity of upper gastrointestinal symptoms were highly similar. The 48-week clinical outcome was also similar but at this time 42% of patients with an initial diagnosis of gastroparesis were reclassified as FD based on gastric-emptying results at this time point; conversely, 37% of patients with FD were reclassified as having gastroparesis. Change in either direction was not associated with any difference in symptom severity changes. Full-thickness biopsies of the stomach showed loss of interstitial cells of Cajal and CD206⁺ macrophages in both groups compared with obese controls. A year after initial classification, patients with FD and gastroparesis, as seen in tertiary referral centers at least, are not distinguishable based on clinical and pathologic features or based on assessment of gastric emptying. Gastric-emptying results are labile and do not reliably capture the pathophysiology of clinical symptoms in either condition. FD and gastroparesis are unified by characteristic pathologic features and should be considered as part of the same spectrum of truly "organic" gastric neuromuscular disorders. NCT00398801 , NCT01696747 [ABSTRACT FROM AUTHOR]

: Copyright of Gastroenterology (00165085) is the property of W B Saunders and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Pasricha, Pankaj J., Grover, Madhusudan, Yates, Katherine P., Abell, Thomas L., Koch, Kenneth L., McCallum, Richard W., Sarosiek, Irene, Bernard, Cheryl E., Kuo, Braden, Bulat, Robert, Shulman, Robert J., Chumpitazi, Bruno P., Tonascia, James, Miriel, Laura A., Wilson, Laura A., Van Natta, Mark L., Mitchell, Emily, Hamilton, Frank, Farrugia, Gianrico, Parkman, Henry P.

المصدر: Clinical Gastroenterology & Hepatology; Dec2022, Vol. 20 Issue 12, p2684-2684, 1p

مستخلص: The Gastroparesis Clinical Research Consortium is a multicenter coalition created and funded by the National Institutes of Diabetes and Digestive and Kidney Disorders, with a mission to advance understanding of the pathophysiology of gastroparesis and develop an effective treatment for patients with symptomatic gastroparesis. In this review, we summarize the results of the published Gastroparesis Clinical Research Consortium studies as a ready and convenient resource for gastroenterologists and others to provide a clear understanding of the consortium's experience and perspective on gastroparesis and related disorders. [ABSTRACT FROM AUTHOR]

: Copyright of Clinical Gastroenterology & Hepatology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Parkman, Henry P., Sharkey, Emily, McCallum, Richard W., Hasler, William L., Koch, Kenneth L., Sarosiek, Irene, Abell, Thomas L., Kuo, Braden, Shulman, Robert J., Grover, Madhusudan, Farrugia, Gianrico, Schey, Ron, Tonascia, James, Hamilton, Frank, Pasricha, Pankaj J.

المصدر: Clinical Gastroenterology & Hepatology; Mar2022, Vol. 20 Issue 3, p546-546, 1p

مستخلص: Constipation can be an important symptom in some patients with gastroparesis. The aims were to: 1) Determine prevalence of constipation and delayed colonic transit in patients with symptoms of gastroparesis; 2) Correlate severity of constipation to severity of symptoms of gastroparesis; and 3) Relate severity of constipation to GI transit delays assessed by gastric emptying scintigraphy (GES) and wireless motility capsule (WMC). Patients with symptoms of gastroparesis underwent gastric emptying scintigraphy (GES), wireless motility capsule (WMC) assessing gastric emptying, small bowel transit, and colonic transit, and questionnaires assessing symptoms using a modified Patient Assessment of Upper GI Symptoms [PAGI-SYM] and Rome III functional GI disorder questionnaire. Of 338 patients with symptoms of gastroparesis, 242 (71.5%) had delayed gastric emptying by scintigraphy; 298 (88.2%) also met criteria for functional dyspepsia. Severity of constipation was severe/very severe in 34% patients, moderate in 24%, and none/very mild/mild in 42%. Increasing severity of constipation was associated with increasing symptoms of gastroparesis and presence of irritable bowel syndrome (IBS). Severity of constipation was not associated with gastric retention on GES or WMC. Delayed colonic transit was present in 108 patients (32% of patients). Increasing severity of constipation was associated with increasing small bowel transit time, colonic transit time, and whole gut transit time. Severe/very severe constipation and delayed colon transit occurs in a third of patients with symptoms of gastroparesis. The severity of constipation is associated with severity of gastroparesis symptoms, presence of IBS, small bowel and colon transit delay, but not delay in gastric emptying. ClinicalTrials.gov Identifier: NCT01696747 [ABSTRACT FROM AUTHOR]

: Copyright of Clinical Gastroenterology & Hepatology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Parkman, Henry P., Yates, Katherine, Hasler, William L., Nguyen, Linda, Pasricha, Pankaj J., Snape, William J., Farrugia, Gianrico, Koch, Kenneth L., Abell, Thomas L., McCallum, Richard W., Lee, Linda, Unalp–Arida, Aynur, Tonascia, James, Hamilton, Frank

المصدر: Gastroenterology (00165085); Jan2011, Vol. 140 Issue 1, p101-115.e10, 0p

مصطلحات موضوعية: GASTRIC emptying, BODY mass index, SEX factors in disease, MEDICAL history taking, INDIGESTION, MEDICAL statistics, C-reactive protein

مستخلص: Background & Aims: Idiopathic gastroparesis (IG) is a common but poorly understood condition with significant morbidity. We studied characteristics of patients with IG enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium Registry. Methods: Data from medical histories, symptom questionnaires, and 4-hour gastric emptying scintigraphy studies were obtained from patients with IG. Results: The mean age of 243 patients with IG studied was 41 years; 88% were female, 46% were overweight, 50% had acute onset of symptoms, and 19% reported an initial infectious prodrome. Severe delay in gastric emptying (>35% retention at 4 hours) was present in 28% of patients. Predominant presenting symptoms were nausea (34%), vomiting (19%), an abdominal pain (23%). Women had more severe nausea, satiety, constipation, and overall gastroparesis symptoms. Patients who experienced acute-onset IG had worse nausea than those with insidious onset. Overweight patients had more bloating and gastric retention at 2 hours but less severe loss of appetite. Patients with severely delayed gastric emptying had worse vomiting and more severe loss of appetite and overall gastroparesis symptoms. Severe anxiety and depression were present in 36% and 18%, respectively. A total of 86% met criteria for functional dyspepsia, primarily postprandial distress syndrome. Conclusions: IG is a disorder that primarily affects young women, beginning acutely in 50% of cases; unexpectedly, many patients are overweight. Severe delay in gastric emptying was associated with more severe symptoms of vomiting and loss of appetite. IG is a diverse syndrome that varies by sex, body mass, symptom onset, and delay in gastric emptying. [ABSTRACT FROM AUTHOR]

: Copyright of Gastroenterology (00165085) is the property of W B Saunders and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)