Functional Dyspepsia and Gastroparesis

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Upper gastrointestinal disorders typically present with common symptoms. The most relevant non-mucosal diseases are gastroparesis, functional dyspepsia and rumination syndrome. The literature pertaining to these 3 conditions was reviewed. Key Messages: Gastroparesis is characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach. The cardinal symptoms include postprandial fullness (early satiety), nausea, vomiting and bloating. The most frequently encountered causes of these symptoms are mechanical obstruction (pyloric stenosis), iatrogenic disease, gastroparesis, functional dyspepsia, cyclical vomiting and rumination syndrome. The most common causes of gastroparesis are neuropathic disorders such as diabetes, idiopathic, post-vagotomy and scleroderma among myopathic disorders. Principles of management of gastroparesis include exclusion of mechanical obstruction with imaging and iatrogenic causes with careful medication and past surgical history. Prokinetics and anti-emetics are the mainstays of treatment. Functional dyspepsia is characterized by the same symptoms as gastroparesis; in addition to delayed gastric emptying, pathophysiological abnormalities include accelerated gastric emptying, impaired gastric accommodation and gastric or duodenal hypersensitivity to distension and nutrients. Novel treatments include tricyclic antidepressants in patients with normal gastric emptying, acotiamide (acetyl cholinesterase inhibitor) and 5-HT1A receptor agonists such as buspirone. Rumination syndrome is characterized by repetitive regurgitation of gastric contents occurring within minutes after a meal. Episodes often persist for 1-2 h after the meal, and the regurgitant consists of partially digested food that is recognizable in its taste. Regurgitation is typically effortless or preceded by a sensation of belching. This has been summarized as a 'meal in, meal out, day in, day out' behavior for weeks or months, differentiating rumination from gastroparesis. Patients often have a background of psychological disorder or a prior eating disorder. Treatment is based on behavioral modification. Conclusion: Precise identification of the cause and pathophysiology of upper gastrointestinal symptoms is essential for optimal management.

Original languageEnglish (US)
Pages (from-to)491-499
Number of pages9
JournalDigestive Diseases
Volume34
Issue number5
DOIs
StatePublished - Jun 1 2016

Fingerprint

Gastroparesis
Dyspepsia
Gastric Emptying
Meals
Stomach
Eructation
Iatrogenic Disease
Pyloric Stenosis
Serotonin 5-HT1 Receptor Agonists
Buspirone
Food
Gastrointestinal Contents
Receptor, Serotonin, 5-HT1A
Antiemetics
Tricyclic Antidepressive Agents
Vagotomy
Cholinesterase Inhibitors
Nausea
Vomiting
Hypersensitivity

Keywords

  • Abdominal pain
  • Bloating
  • Nausea
  • Regurgitation
  • Rumination
  • Vomiting

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Functional Dyspepsia and Gastroparesis. / Camilleri, Michael.

In: Digestive Diseases, Vol. 34, No. 5, 01.06.2016, p. 491-499.

Research output: Contribution to journalArticle

@article{0b69646899cb48e586f403c31138a4be,
title = "Functional Dyspepsia and Gastroparesis",
abstract = "Background: Upper gastrointestinal disorders typically present with common symptoms. The most relevant non-mucosal diseases are gastroparesis, functional dyspepsia and rumination syndrome. The literature pertaining to these 3 conditions was reviewed. Key Messages: Gastroparesis is characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach. The cardinal symptoms include postprandial fullness (early satiety), nausea, vomiting and bloating. The most frequently encountered causes of these symptoms are mechanical obstruction (pyloric stenosis), iatrogenic disease, gastroparesis, functional dyspepsia, cyclical vomiting and rumination syndrome. The most common causes of gastroparesis are neuropathic disorders such as diabetes, idiopathic, post-vagotomy and scleroderma among myopathic disorders. Principles of management of gastroparesis include exclusion of mechanical obstruction with imaging and iatrogenic causes with careful medication and past surgical history. Prokinetics and anti-emetics are the mainstays of treatment. Functional dyspepsia is characterized by the same symptoms as gastroparesis; in addition to delayed gastric emptying, pathophysiological abnormalities include accelerated gastric emptying, impaired gastric accommodation and gastric or duodenal hypersensitivity to distension and nutrients. Novel treatments include tricyclic antidepressants in patients with normal gastric emptying, acotiamide (acetyl cholinesterase inhibitor) and 5-HT1A receptor agonists such as buspirone. Rumination syndrome is characterized by repetitive regurgitation of gastric contents occurring within minutes after a meal. Episodes often persist for 1-2 h after the meal, and the regurgitant consists of partially digested food that is recognizable in its taste. Regurgitation is typically effortless or preceded by a sensation of belching. This has been summarized as a 'meal in, meal out, day in, day out' behavior for weeks or months, differentiating rumination from gastroparesis. Patients often have a background of psychological disorder or a prior eating disorder. Treatment is based on behavioral modification. Conclusion: Precise identification of the cause and pathophysiology of upper gastrointestinal symptoms is essential for optimal management.",
keywords = "Abdominal pain, Bloating, Nausea, Regurgitation, Rumination, Vomiting",
author = "Michael Camilleri",
year = "2016",
month = "6",
day = "1",
doi = "10.1159/000445226",
language = "English (US)",
volume = "34",
pages = "491--499",
journal = "Digestive Diseases",
issn = "0257-2753",
publisher = "S. Karger AG",
number = "5",

}

TY - JOUR

T1 - Functional Dyspepsia and Gastroparesis

AU - Camilleri, Michael

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Background: Upper gastrointestinal disorders typically present with common symptoms. The most relevant non-mucosal diseases are gastroparesis, functional dyspepsia and rumination syndrome. The literature pertaining to these 3 conditions was reviewed. Key Messages: Gastroparesis is characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach. The cardinal symptoms include postprandial fullness (early satiety), nausea, vomiting and bloating. The most frequently encountered causes of these symptoms are mechanical obstruction (pyloric stenosis), iatrogenic disease, gastroparesis, functional dyspepsia, cyclical vomiting and rumination syndrome. The most common causes of gastroparesis are neuropathic disorders such as diabetes, idiopathic, post-vagotomy and scleroderma among myopathic disorders. Principles of management of gastroparesis include exclusion of mechanical obstruction with imaging and iatrogenic causes with careful medication and past surgical history. Prokinetics and anti-emetics are the mainstays of treatment. Functional dyspepsia is characterized by the same symptoms as gastroparesis; in addition to delayed gastric emptying, pathophysiological abnormalities include accelerated gastric emptying, impaired gastric accommodation and gastric or duodenal hypersensitivity to distension and nutrients. Novel treatments include tricyclic antidepressants in patients with normal gastric emptying, acotiamide (acetyl cholinesterase inhibitor) and 5-HT1A receptor agonists such as buspirone. Rumination syndrome is characterized by repetitive regurgitation of gastric contents occurring within minutes after a meal. Episodes often persist for 1-2 h after the meal, and the regurgitant consists of partially digested food that is recognizable in its taste. Regurgitation is typically effortless or preceded by a sensation of belching. This has been summarized as a 'meal in, meal out, day in, day out' behavior for weeks or months, differentiating rumination from gastroparesis. Patients often have a background of psychological disorder or a prior eating disorder. Treatment is based on behavioral modification. Conclusion: Precise identification of the cause and pathophysiology of upper gastrointestinal symptoms is essential for optimal management.

AB - Background: Upper gastrointestinal disorders typically present with common symptoms. The most relevant non-mucosal diseases are gastroparesis, functional dyspepsia and rumination syndrome. The literature pertaining to these 3 conditions was reviewed. Key Messages: Gastroparesis is characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach. The cardinal symptoms include postprandial fullness (early satiety), nausea, vomiting and bloating. The most frequently encountered causes of these symptoms are mechanical obstruction (pyloric stenosis), iatrogenic disease, gastroparesis, functional dyspepsia, cyclical vomiting and rumination syndrome. The most common causes of gastroparesis are neuropathic disorders such as diabetes, idiopathic, post-vagotomy and scleroderma among myopathic disorders. Principles of management of gastroparesis include exclusion of mechanical obstruction with imaging and iatrogenic causes with careful medication and past surgical history. Prokinetics and anti-emetics are the mainstays of treatment. Functional dyspepsia is characterized by the same symptoms as gastroparesis; in addition to delayed gastric emptying, pathophysiological abnormalities include accelerated gastric emptying, impaired gastric accommodation and gastric or duodenal hypersensitivity to distension and nutrients. Novel treatments include tricyclic antidepressants in patients with normal gastric emptying, acotiamide (acetyl cholinesterase inhibitor) and 5-HT1A receptor agonists such as buspirone. Rumination syndrome is characterized by repetitive regurgitation of gastric contents occurring within minutes after a meal. Episodes often persist for 1-2 h after the meal, and the regurgitant consists of partially digested food that is recognizable in its taste. Regurgitation is typically effortless or preceded by a sensation of belching. This has been summarized as a 'meal in, meal out, day in, day out' behavior for weeks or months, differentiating rumination from gastroparesis. Patients often have a background of psychological disorder or a prior eating disorder. Treatment is based on behavioral modification. Conclusion: Precise identification of the cause and pathophysiology of upper gastrointestinal symptoms is essential for optimal management.

KW - Abdominal pain

KW - Bloating

KW - Nausea

KW - Regurgitation

KW - Rumination

KW - Vomiting

UR - http://www.scopus.com/inward/record.url?scp=84976330203&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976330203&partnerID=8YFLogxK

U2 - 10.1159/000445226

DO - 10.1159/000445226

M3 - Article

C2 - 27332558

AN - SCOPUS:84976330203

VL - 34

SP - 491

EP - 499

JO - Digestive Diseases

JF - Digestive Diseases

SN - 0257-2753

IS - 5

ER -