Gastroparesis Updates on Pathogenesis and Management.

Gastroparesis Updates on Pathogenesis and Management.
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DOI:
10.5009/gnl16336
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发表时间:
2017-09-15
期刊:
影响因子:
3.4
通讯作者:
Abell T
Abell T
中科院分区:
医学3区
文献类型:
--
作者:
Liu N;Abell T

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胃轻瘫(Gp)是一种慢性疾病,临床表现为早饱、腹胀、恶心、呕吐和腹痛。沿着这些症状,需要胃排空延迟的客观发现,沿着有胃出口梗阻的记录,以进行诊断。本文重点介绍GP的发病机制和治疗的最新进展。最近对GP患者的全层活检的研究揭示了中枢、自主神经和肠神经系统的复杂相互作用,这些系统在维持正常的肠道运动中都起着关键作用。随着胃电刺激器(GES)的使用,GP的治疗已经超越了促动力剂和止吐剂。此外,本文旨在介绍胃瘫样综合征(GLS)的概念。GLS帮助有GP主要症状但排空试验正常或快速的患者。最近的试验表明,Gp和GLS患者具有相似的病理生理学,从GES放置中获益很大,并且可能应以相似的方式进行治疗。
Gastroparesis (Gp) is a chronic disease that presents with clinical symptoms of early satiety, bloating, nausea, vomiting, and abdominal pain. Along with these symptoms, an objective finding of delayed gastric emptying, along with a documented absence of gastric outlet obstruction, are required for diagnosis. This article focuses on updates in the pathogenesis and management of Gp. Recent studies on full thickness biopsies of Gp patients have shed light on the complex interactions of the central, autonomic, and enteric nervous systems, which all play key roles in maintaining normal gut motility. The management of Gp has evolved beyond prokinetics and antiemetics with the use of gastric electrical stimulators (GES). In addition, this review aims to introduce the concept of gastroparesis-like syndrome (GLS). GLS helps groups of patients who have the cardinal symptoms of Gp but have a normal or rapid emptying test. Recent tests have shown that patients with Gp and GLS have similar pathophysiology, benefit greatly from GES placement, and likely should be treated in a similar manner.
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