Disease relevance of Gastroparesis

• Effect of six weeks of treatment with cisapride in gastroparesis and intestinal pseudoobstruction [1].
• In a double blind crossover comparison with placebo, the effects of cisapride (10 mg tid for two weeks), a non-antidopaminergic gastrointestinal prokinetic drug, on gastric emptying times and on symptoms were evaluated in 12 patients with chronic idiopathic dyspepsia and gastroparesis [2].
• Multifocal myoclonic jerking developed in our patient after he received metoclopramide therapy for gastroparesis due to renal failure [3].
• OBJECTIVE--To evaluate the effect of gastric emptying on postprandial insulin requirement in insulin-dependent diabetes mellitus (IDDM) patients with and without gastroparesis [4].
• Gastric emptying of technetium labeled liquid and solid meals were studied in a group of long-standing, insulin-requiring male diabetics to evaluate the relationship of gastroparesis to symptoms, diabetic control, and diabetic complications [5].

Psychiatry related information on Gastroparesis

• First-line treatments include midodrine for orthostatic hypotension, prokinetic drugs for gastroparesis, broad-spectrum antibiotics for diabetic diarrhea, and sildenafil for erectile dysfunction [6].

High impact information on Gastroparesis

• These preliminary results suggest that erythromycin may have therapeutic value in patients with severe diabetic gastroparesis [7].
• Pretreatment with mast cell stabilizers ketotifen (1 mg/kg, p.o.) or doxantrazole (5 mg/kg, i.p.) prevented both manipulation-induced inflammation and gastroparesis [8].
• These findings offer insight into the myoelectric disturbances of diabetic gastroparesis and suggest a possible therapeutic role for prostaglandin synthesis inhibitors for gastric dysrhythmias in this condition [9].
• Effect of motilin on gastric emptying in patients with diabetic gastroparesis [10].
• Our data show that motilin accelerates gastric emptying in diabetic gastroparesis and support the hypothesis that erythromycin's effect is mediated through motilin receptors [10].

Chemical compound and disease context of Gastroparesis

• Cisapride in postoperative gastroparesis [11].
• Administration of metoclopramide initiated antral phase III activities in healthy controls and in patients with diabetic gastroparesis [12].
• Domperidone in reflux oesophagitis and gastric stasis [13].
• Gastric motor abnormalities in diabetic and postvagotomy gastroparesis: effect of metoclopramide and bethanechol [14].
• The abdominal vagus nerves from 5 diabetics (2 with gastroparesis) and 12 nondiabetic controls were stained with hematoxylin and eosin, Gomori trichrome, luxol-fast blue, and Holmes' silver stains [15].

Biological context of Gastroparesis

• This study indicates that acute, intravenous administration of cisapride accelerates gastric emptying of indigestible solids in patients with diabetic gastroparesis [16].
• We conclude that diabetic gastroparesis is associated with absence of antral interdigestive migrating motor complex and with elevated plasma motilin concentration with normal cyclic fluctuations [12].
• The gastrointestinal prokinetic drug, cisapride, is widely used for the treatment of diabetic gastroparesis and disorders of gastrointestinal motility [17].
• Pharmacokinetics of the conventional and microemulsion formulations of cyclosporine in pancreas-kidney transplant recipients with gastroparesis [18].
• Bioavailability and disposition of metoclopramide after single- and multiple-dose administration in diabetic patients with gastroparesis [19].

Anatomical context of Gastroparesis

• CONCLUSIONS: Gastric stasis after a pylorus-preserving pancreatoduodenectomy may be in part attributable to the low concentration of plasma motilin caused by the resection of the duodenum [20].
• Dopamine antagonists such as domperidone appear to have maximal prokinetic effect in the proximal gastrointestinal tract and are effective for such conditions as gastroparesis and gastroesophageal reflux, but they appear to have little physiologic effect in the colon or in colonic motility disorders [21].
• In particular, impaired nNOS synthesis of the myenteric plexus seems to be an important contributing factor to the pathogenesis of achalasia, diabetic gastroparesis, infantile hypertrophic pyloric stenosis, Hirschsprung's disease, and Chagas' disease [22].
• Refractory spinal cord injury induced gastroparesis: resolution with erythromycin lactobionate, a case report [23].
• Late findings included aspiration (9 patients), anastomotic strictures (8), gastric stasis (6), redundancy and tortuosity of the colon (5), anastomotic ulcers (4), gastrocolic reflux (3), and gastroesophageal reflux into the residual esophagus (2) [24].

Gene context of Gastroparesis

• METHODS: Ten insulin requiring diabetic patients (five men, six type I) referred with symptoms indicative of gastroparesis received a two hour infusion of either ghrelin (5 pmol/kg/min) or saline on two occasions [25].
• The selective nonpeptide CRF-R1 antagonists antalarmin (20 mg/kg ip) and NBI-27914 (400 microgram/kg iv) did not influence intravenous CRF-, urocortin- or surgery-induced gastric stasis [26].
• These observations suggest a potential for ghrelin receptor agonists in the treatment of gastroparesis [27].
• Effects of lipopolysaccharide on gastric stasis: role of cyclooxygenase [28].
• The new CRF antagonist [DPhe12, Nle21,38, C alpha MeLeu37]-CRF12-41 (20 micrograms/rat), injected intracisternally, or indomethacin (5 mg/kg i.p.) completely abolished IL-1 beta (3 ng/rat i.v.)-induced gastric stasis [29].

Analytical, diagnostic and therapeutic context of Gastroparesis

• Effect of leucine 13-motilin (KW5139) on early gastric stasis after pylorus-preserving pancreatoduodenectomy [30].
• Major developments in nutrient delivery have included percutaneous endoscopic feeding devices, the recognition that enteral feeding is possible in patients with gastric stasis, and that nutrient needs can be met by peripheral parenteral nutrition [31].
• The treatment of gastroparesis recently received a heavy blow from the restrictions on the use of the prokinetic drug cisapride, but, fortunately, at the same time, a nonpharmacological approach, such as gastric electrical stimulation, came up again with new techniques [32].
• METHODS: A MEDLINE search from 1966 to 2001 was performed to identify all clinical trials using erythromycin in patients with gastroparesis [33].
• Intraperitoneal erythromycin for diabetic gastroparesis in CAPD [34].

References