Gastroduodenal motility.
OBJECTIVE
Abnormalities of gastroduodenal motility are considered key players in the pathogenesis of upper gastrointestinal symptoms in disorders such as functional dyspepsia and gastroparesis. Abnormalities of sensory control are considered another important factor that contributes to symptom generation. This review summarizes recent progress in our understanding of gastroduodenal motility and sensitivity in health and in disease.


RESULTS
Although gastric and small intestinal motility remain an important focus of research, including the application of the SmartPill (SmartPill Corp., Buffalo, New York, USA) wireless motility monitoring capsule, duodenal sensitivity and low-grade duodenal inflammation are new areas of interest in the pathogenesis of functional dyspepsia. A number of genetic polymorphisms associated with functional dyspepsia are being investigated, but large-scale studies are still lacking. Central processing of visceral stimuli, and its role in the pathogenesis of functional dyspepsia, is another important emerging topic. Therapeutic studies have reported on novel pharmacological approaches in functional dyspepsia and gastroparesis, as well as gastric electrical stimulation in the treatment of refractory gastroparesis.


CONCLUSIONS
There is gradual progress in our understanding of the pathogenesis of gastroduodenal symptoms. Areas of recent advances including the recognition of low-grade duodenal inflammation, the role of central nervous system processing in visceral hypersensitivity and the exploration of novel pharmacotherapeutic approaches.
Tack
Jan
J
Translational Research Center for Gastrointestinal Diseases (TARGID), University of Leuven, University Hospital Gasthuisberg, Leuven, Belgium. jan.tack@med.kuleuven.ac.be
Janssen
Pieter
P
D004415:Dyspepsia / Q000188:drug therapy / Q000503:physiopathology*; D005769:Gastrointestinal Motility / Q000187:drug effects* / Q000502:physiology*; D018589:Gastroparesis / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007422:Intestines / Q000502:physiology / Q000503:physiopathology; D043643:Receptor, Muscarinic M1 / Q000037:antagonists & inhibitors; D043585:Receptor, Muscarinic M2 / Q000037:antagonists & inhibitors; D054440:Receptors, Ghrelin / Q000819:agonists; D012677:Sensation / Q000502:physiology*; D058828:Serotonin 5-HT4 Receptor Agonists / Q000494:pharmacology / Q000627:therapeutic use; D013270:Stomach / Q000502:physiology / Q000503:physiopathology
D043643:Receptor, Muscarinic M1; D043585:Receptor, Muscarinic M2; D054440:Receptors, Ghrelin; D058828:Serotonin 5-HT4 Receptor Agonists