Pathophysiology of Gastroparesis Syndromes Includes Anatomic and Physiologic
Authors Abell TL, Kedar A, Stocker A, Beatty K, McElmurray L, Hughes M, Rashed H,
Kennedy W, Wendelschafer-Crabb G, Yang X, Fraig M, Gobejishvili L, Omer E,
Miller E, Griswold M, Pinkston C
Submitted By Submitted Externally on 4/28/2020
Status Published
Journal Digestive diseases and sciences
Year 2020
Date Published 4/1/2020
Volume : Pages Not Specified : Not Specified
PubMed Reference 32328893
Abstract Factors underlying gastroparesis are not well defined., We hypothesized that
multiple systems may be involved in patients with gastroparesis symptoms and
performed a comparative physiologic study., We studied 43 consecutive eligible
patients with gastroparetic symptoms categorized by GI symptoms, metabolic
status, illness quantification, and gastric physiology. Patients were evaluated
by two methods in each of five core areas: inflammatory, autonomic, enteric,
electrophysiologic, and hormonal with abnormalities examined by correlations.,
Patients had similar GI symptoms regardless of baseline gastric emptying or
diabetic/idiopathic status, and all patients demonstrated abnormalities in each
of the 5 areas studied. Nearly all patients presented with elevated markers of
serum TNFa (88%) and serum IL-6 (91%); elevated cutaneous electrogastrogram
frequency (95%); and interstitial cells of Cajal count abnormalities (inner:
97%, outer: 100%). Measures of inflammation correlated with a number of
autonomic, enteric anatomy, electrophysiologic and hormonal abnormalities., We
conclude that patients with the symptoms of gastroparesis have multiple
abnormalities, when studied by traditional, as well as newer, diagnostic
assessments. Inflammation appears to be a fundamental abnormality that affects
other organ systems in symptomatic patients. Future work on gastroparetic
syndromes and their treatment may benefit from a focus on the diffuse nature of
their illness, diverse pathophysiologic mechanisms involved, especially the
possible causes of underlying inflammation and disordered hormonal status., This
study is registered with under study # NCT03178370