Malignant gastroparesis: Pathogenesis and management of an underrecognized disorder

Kavitha R. Donthireddy, Sikander Ailawadhi, Eiad Nasser, Michael D. Schiff, Chukwumere E. Nwogu, Hector R. Nava, Milind M. Javle

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

Gastroparesis is a disorder of the stomach caused by delayed gastric emptying in the absence of mechanical obstruction. Symptoms of gastroparesis include nausea, vomiting, early satiety, bloating, and abdominal discomfort. Gastroparesis has been described as a complication of several malignancies, including gastric, pancreatic, gallbladder, esophageal, and lung cancers, as well as leiomyosarcoma. The prevalence of malignant gastroparesis (MG) is unknown, and this entity is widely underrecognized and undertreated. Diabetes mellitus is the most common identifiable cause of benign gastroparesis, ie, gastroparesis occurring in the absence of an underlying malignant pathology. In the setting of malignancy, gastroparesis may result from the cancer itself or may be a complication of its treatment with such modalities as surgery, radiation therapy, or chemotherapy. Coexisting conditions, including diabetes, hypothyroidism, and neurologic diseases, may further exacerbate MG. The pathogenesis of MG is not clearly understood at present. However, mechanisms suggested in the literature include postvagotomy syndrome, malignant infiltration of the autonomic nervous system, and paraneoplastic dysmotility with autoantibody-mediated destruction of the enteric nervous system (the interstitial cells of Cajal, also called the intrinsic pacemaker of the gastrointestinal tract, or the myenteric plexus). Appropriate treatment of MG may help to avoid serious consequences, such as cancer cachexia, intolerance of oral anticancer agents, dehydration, and hospitalization. In this article, we will describe our institutional experience with MG and will provide a concise review of the literature. Guidelines for management will be suggested.

Original languageEnglish (US)
Pages (from-to)355-363
Number of pages9
JournalJournal of Supportive Oncology
Volume5
Issue number8
StatePublished - Sep 2007
Externally publishedYes

Fingerprint

Gastroparesis
Neoplasms
Interstitial Cells of Cajal
Enteric Nervous System
Gallbladder Neoplasms
Myenteric Plexus
Cachexia
Leiomyosarcoma
Gastric Emptying
Autonomic Nervous System
Esophageal Neoplasms
Hypothyroidism
Nervous System Diseases
Pancreatic Neoplasms
Dehydration
Antineoplastic Agents
Autoantibodies
Nausea
Stomach Neoplasms
Vomiting

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Donthireddy, K. R., Ailawadhi, S., Nasser, E., Schiff, M. D., Nwogu, C. E., Nava, H. R., & Javle, M. M. (2007). Malignant gastroparesis: Pathogenesis and management of an underrecognized disorder. Journal of Supportive Oncology, 5(8), 355-363.

Malignant gastroparesis : Pathogenesis and management of an underrecognized disorder. / Donthireddy, Kavitha R.; Ailawadhi, Sikander; Nasser, Eiad; Schiff, Michael D.; Nwogu, Chukwumere E.; Nava, Hector R.; Javle, Milind M.

In: Journal of Supportive Oncology, Vol. 5, No. 8, 09.2007, p. 355-363.

Research output: Contribution to journalReview article

Donthireddy, KR, Ailawadhi, S, Nasser, E, Schiff, MD, Nwogu, CE, Nava, HR & Javle, MM 2007, 'Malignant gastroparesis: Pathogenesis and management of an underrecognized disorder', Journal of Supportive Oncology, vol. 5, no. 8, pp. 355-363.
Donthireddy KR, Ailawadhi S, Nasser E, Schiff MD, Nwogu CE, Nava HR et al. Malignant gastroparesis: Pathogenesis and management of an underrecognized disorder. Journal of Supportive Oncology. 2007 Sep;5(8):355-363.
Donthireddy, Kavitha R. ; Ailawadhi, Sikander ; Nasser, Eiad ; Schiff, Michael D. ; Nwogu, Chukwumere E. ; Nava, Hector R. ; Javle, Milind M. / Malignant gastroparesis : Pathogenesis and management of an underrecognized disorder. In: Journal of Supportive Oncology. 2007 ; Vol. 5, No. 8. pp. 355-363.
@article{46331cf36b994373937aa7e2132e2e5f,
title = "Malignant gastroparesis: Pathogenesis and management of an underrecognized disorder",
abstract = "Gastroparesis is a disorder of the stomach caused by delayed gastric emptying in the absence of mechanical obstruction. Symptoms of gastroparesis include nausea, vomiting, early satiety, bloating, and abdominal discomfort. Gastroparesis has been described as a complication of several malignancies, including gastric, pancreatic, gallbladder, esophageal, and lung cancers, as well as leiomyosarcoma. The prevalence of malignant gastroparesis (MG) is unknown, and this entity is widely underrecognized and undertreated. Diabetes mellitus is the most common identifiable cause of benign gastroparesis, ie, gastroparesis occurring in the absence of an underlying malignant pathology. In the setting of malignancy, gastroparesis may result from the cancer itself or may be a complication of its treatment with such modalities as surgery, radiation therapy, or chemotherapy. Coexisting conditions, including diabetes, hypothyroidism, and neurologic diseases, may further exacerbate MG. The pathogenesis of MG is not clearly understood at present. However, mechanisms suggested in the literature include postvagotomy syndrome, malignant infiltration of the autonomic nervous system, and paraneoplastic dysmotility with autoantibody-mediated destruction of the enteric nervous system (the interstitial cells of Cajal, also called the intrinsic pacemaker of the gastrointestinal tract, or the myenteric plexus). Appropriate treatment of MG may help to avoid serious consequences, such as cancer cachexia, intolerance of oral anticancer agents, dehydration, and hospitalization. In this article, we will describe our institutional experience with MG and will provide a concise review of the literature. Guidelines for management will be suggested.",
author = "Donthireddy, {Kavitha R.} and Sikander Ailawadhi and Eiad Nasser and Schiff, {Michael D.} and Nwogu, {Chukwumere E.} and Nava, {Hector R.} and Javle, {Milind M.}",
year = "2007",
month = "9",
language = "English (US)",
volume = "5",
pages = "355--363",
journal = "Journal of Supportive Oncology",
issn = "1544-6794",
publisher = "Biolink Communications, Inc.",
number = "8",

}

TY - JOUR

T1 - Malignant gastroparesis

T2 - Pathogenesis and management of an underrecognized disorder

AU - Donthireddy, Kavitha R.

AU - Ailawadhi, Sikander

AU - Nasser, Eiad

AU - Schiff, Michael D.

AU - Nwogu, Chukwumere E.

AU - Nava, Hector R.

AU - Javle, Milind M.

PY - 2007/9

Y1 - 2007/9

N2 - Gastroparesis is a disorder of the stomach caused by delayed gastric emptying in the absence of mechanical obstruction. Symptoms of gastroparesis include nausea, vomiting, early satiety, bloating, and abdominal discomfort. Gastroparesis has been described as a complication of several malignancies, including gastric, pancreatic, gallbladder, esophageal, and lung cancers, as well as leiomyosarcoma. The prevalence of malignant gastroparesis (MG) is unknown, and this entity is widely underrecognized and undertreated. Diabetes mellitus is the most common identifiable cause of benign gastroparesis, ie, gastroparesis occurring in the absence of an underlying malignant pathology. In the setting of malignancy, gastroparesis may result from the cancer itself or may be a complication of its treatment with such modalities as surgery, radiation therapy, or chemotherapy. Coexisting conditions, including diabetes, hypothyroidism, and neurologic diseases, may further exacerbate MG. The pathogenesis of MG is not clearly understood at present. However, mechanisms suggested in the literature include postvagotomy syndrome, malignant infiltration of the autonomic nervous system, and paraneoplastic dysmotility with autoantibody-mediated destruction of the enteric nervous system (the interstitial cells of Cajal, also called the intrinsic pacemaker of the gastrointestinal tract, or the myenteric plexus). Appropriate treatment of MG may help to avoid serious consequences, such as cancer cachexia, intolerance of oral anticancer agents, dehydration, and hospitalization. In this article, we will describe our institutional experience with MG and will provide a concise review of the literature. Guidelines for management will be suggested.

AB - Gastroparesis is a disorder of the stomach caused by delayed gastric emptying in the absence of mechanical obstruction. Symptoms of gastroparesis include nausea, vomiting, early satiety, bloating, and abdominal discomfort. Gastroparesis has been described as a complication of several malignancies, including gastric, pancreatic, gallbladder, esophageal, and lung cancers, as well as leiomyosarcoma. The prevalence of malignant gastroparesis (MG) is unknown, and this entity is widely underrecognized and undertreated. Diabetes mellitus is the most common identifiable cause of benign gastroparesis, ie, gastroparesis occurring in the absence of an underlying malignant pathology. In the setting of malignancy, gastroparesis may result from the cancer itself or may be a complication of its treatment with such modalities as surgery, radiation therapy, or chemotherapy. Coexisting conditions, including diabetes, hypothyroidism, and neurologic diseases, may further exacerbate MG. The pathogenesis of MG is not clearly understood at present. However, mechanisms suggested in the literature include postvagotomy syndrome, malignant infiltration of the autonomic nervous system, and paraneoplastic dysmotility with autoantibody-mediated destruction of the enteric nervous system (the interstitial cells of Cajal, also called the intrinsic pacemaker of the gastrointestinal tract, or the myenteric plexus). Appropriate treatment of MG may help to avoid serious consequences, such as cancer cachexia, intolerance of oral anticancer agents, dehydration, and hospitalization. In this article, we will describe our institutional experience with MG and will provide a concise review of the literature. Guidelines for management will be suggested.

UR - http://www.scopus.com/inward/record.url?scp=35248898257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=35248898257&partnerID=8YFLogxK

M3 - Review article

C2 - 17944143

AN - SCOPUS:35248898257

VL - 5

SP - 355

EP - 363

JO - Journal of Supportive Oncology

JF - Journal of Supportive Oncology

SN - 1544-6794

IS - 8

ER -