title: Pathophysiology and pharmacotherapy of gastroparesis: current and future perspectives.
abstract: BACKGROUND
  Gastroparesis is an important clinical disorder characterised by delayed gastric emptying in the absence of mechanical outlet obstruction. Idiopathic, diabetes and postsurgical causes represent the most common aetiologies. The condition commonly manifests as upper gastrointestinal symptoms, including nausea, vomiting, postprandial fullness, early satiety, abdominal pain and bloating.
  
  
  METHODS
  This paper provides a review of the prevalence, pathophysiology and clinical features associated with gastroparesis, with a particular focus on current pharmacological management options and novel and emerging therapies. A literature search was undertaken using the search terms: gastroparesis, diabetic gastroparesis, idiopathic gastroparesis, gastric emptying, prokinetic, metoclopramide, domperidone, erythromycin, motilin, alemcinal, KC11458, mitemcinal, ghrelin, TZP-101, TZP-102, RM-131, tegaserod, prucalopride, naronapride, velusetrag, levosulpiride, itopride, botulinum toxin, gastric electrical stimulation, Enterra.
  
  
  CONCLUSIONS
  Strategies for the management of gastroparesis include correction of malnutrition, dehydration and electrolyte imbalance, relief of symptoms by appropriate use of prokinetic and antiemetic agents and, in patients with gastroparesis associated with diabetes or critical illness-induced hyperglycaemia, optimisation of glycaemic control. Conventional prokinetic agents form the mainstay of treatment. While novel pharmacotherapies are in development, compelling evidence for their efficacy, particularly in symptom relief, remains to be established.
authors.affiliation: University of South Australia, School of Pharmacy and Medical Sciences, Adelaide, Australia. julie.stevens@unisa.edu.au
authors.forename: Julie E
authors.initials: JE
authors.lastname: Stevens
authors.forename: Karen L
authors.initials: KL
authors.lastname: Jones
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Rayner
authors.forename: Michael
authors.initials: M
authors.lastname: Horowitz
mesh_terms: D000818:Animals; D001786:Blood Glucose; D048909:Diabetes Complications / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy; D015195:Drug Design; D005746:Gastric Emptying / Q000187:drug effects*; D005769:Gastrointestinal Motility / Q000502:physiology; D018589:Gastroparesis / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D006801:Humans
chemical_list: D001786:Blood Glucose