title: Gastroparesis: separate entity or just a part of dyspepsia?
abstract: Gastroparesis is defined by the presence of delayed gastric emptying (GE) in the absence of mechanical obstruction. Symptoms that have been attributed to gastroparesis include postprandial fullness, early satiation nausea and vomiting. Gastroprokinetic drugs are the preferred treatment option. A number of problems with the concept of gastroparesis have been identified recently. Major overlap exists with the symptom complex of the functional dyspepsia subtype of postprandial distress syndrome. The distinguishing feature of gastroparesis is delayed GE, but the correlation between delayed emptying and symptom pattern or severity in gastroparesis is modest and the stability of delayed emptying over time is poor. Other pathophysiological mechanisms such as hypersensitivity or impaired accommodation may also underlie symptoms in patients with gastroparesis. Moreover, symptomatic response to prokinetic therapy is variable and cannot be predicted based on the degree of enhancing GE. A number of approaches have been proposed to increase clinical usefulness of a diagnosis of gastroparesis, including a higher threshold of abnormal emptying and selection of patients with a specific symptom pattern more likely to be associated with delayed emptying.
authors.affiliation: Department of Digestive Diseases and Internal Medicine, University of Bologna, St Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Stanghellini
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Tack
mesh_terms: D003937:Diagnosis, Differential; D004415:Dyspepsia / Q000503:physiopathology*; D005746:Gastric Emptying / Q000187:drug effects*; D005765:Gastrointestinal Agents / Q000494:pharmacology / Q000627:therapeutic use; D018589:Gastroparesis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D012720:Severity of Illness Index; D013270:Stomach / Q000503:physiopathology; D063189:Symptom Assessment; D009626:Terminology as Topic
chemical_list: D005765:Gastrointestinal Agents
keywords: FUNCTIONAL DYSPEPSIA; GASTRIC EMPTYING; GASTROPARESIS; PROKINETIC AGENT