TY - JOUR
T1 - Gastroparesis in the 2020s
T2 - New Treatments, New Paradigms
AU - Sharma, Amol
AU - Coles, Michael
AU - Parkman, Henry P.
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Purpose of Review: This review highlights recent work that will lead to near-term advances in the understanding and treatment of gastroparesis (Gp). Recent Findings: Major current advancements in the pathophysiology of Gp, include recognition of the SIP syncytium as the pacemaking unit rather than ICC alone and that Gp may be part of a pan-enteric autoimmune and/or autonomic disorder with macrophage imbalance. The development of newer techniques to assess gastric emptying (gastric emptying breath test and wireless motility capsule) and pyloric distensibility (EndoFLIP®) are allowing clinicians better characterization of their patients. In addition to pharmaceutical compounds in the pipeline, neuromodulation and endosurgical techniques, such as G-POEM, may help address refractory Gp. Summary: We expect that the 2020 decade will witness exciting developments. Treatments targeting gastrointestinal motility, immunological dysfunction, and inflammatory mediators will be evaluated. We anticipate future studies will be guided by biomarkers correlated with patient outcomes and therapeutic efficacy to establish new paradigms in the management of Gp.
AB - Purpose of Review: This review highlights recent work that will lead to near-term advances in the understanding and treatment of gastroparesis (Gp). Recent Findings: Major current advancements in the pathophysiology of Gp, include recognition of the SIP syncytium as the pacemaking unit rather than ICC alone and that Gp may be part of a pan-enteric autoimmune and/or autonomic disorder with macrophage imbalance. The development of newer techniques to assess gastric emptying (gastric emptying breath test and wireless motility capsule) and pyloric distensibility (EndoFLIP®) are allowing clinicians better characterization of their patients. In addition to pharmaceutical compounds in the pipeline, neuromodulation and endosurgical techniques, such as G-POEM, may help address refractory Gp. Summary: We expect that the 2020 decade will witness exciting developments. Treatments targeting gastrointestinal motility, immunological dysfunction, and inflammatory mediators will be evaluated. We anticipate future studies will be guided by biomarkers correlated with patient outcomes and therapeutic efficacy to establish new paradigms in the management of Gp.
KW - Gastric emptying breath test
KW - Gastric emptying scintigraphy
KW - Gastroparesis
KW - Neuromodulation
KW - Pro-motility agents
KW - Wireless motility capsule
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U2 - 10.1007/s11894-020-00761-7
DO - 10.1007/s11894-020-00761-7
M3 - Review article
C2 - 32193707
AN - SCOPUS:85081994869
SN - 1522-8037
VL - 22
JO - Current Gastroenterology Reports
JF - Current Gastroenterology Reports
IS - 5
M1 - 23
ER -