Diabetic gastroparesis: current challenges and future prospects
Danny J Avalos,1 Irene Sarosiek,1 Priyadarshini Loganathan,2 Richard W McCallum1 1Division of Gastroenterology, Center for Neurogastroenterology and GI Motility, Texas Tech University Health Sciences Center, El Paso, TX, USA; 2Department of Internal Medicine, Texas Tech University Health Sciences Ce...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-09-01
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| Series: | Clinical and Experimental Gastroenterology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/diabetic-gastroparesis-current-challenges-and-future-prospects-peer-reviewed-article-CEG |
| _version_ | 1819172828433350656 |
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| author | Avalos DJ Sarosiek I Loganathan P McCallum RW |
| author_facet | Avalos DJ Sarosiek I Loganathan P McCallum RW |
| author_sort | Avalos DJ |
| collection | DOAJ |
| description | Danny J Avalos,1 Irene Sarosiek,1 Priyadarshini Loganathan,2 Richard W McCallum1 1Division of Gastroenterology, Center for Neurogastroenterology and GI Motility, Texas Tech University Health Sciences Center, El Paso, TX, USA; 2Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA Abstract: Diabetic gastroparesis (DMGP) is a condition of delayed gastric emptying after gastric outlet obstruction has been excluded. Symptoms of nausea, vomiting, early satiety, bloating, and abdominal pain are associated with DMGP. Uncontrolled symptoms can lead to overall poor quality of life and financial burdens on the healthcare system. A combination of antiemetics and prokinetics is used in symptom control; metoclopramide is the main prokinetic available for clinical use and is the only U.S. Food and Drug Administration-approved agent in the United States. However, a black box warning in 2009 reporting its association with tardive dyskinesia and recommending caution in chronically using this agent beyond 3 months has decreased its role in clinical practice. There is an unmet need for new prokinetics with good efficacy and safety profiles. Currently, there are several new drugs with different mechanisms of action in the pipeline that are under investigation and show promising preliminary results. Surgically combining gastric electrical stimulation with pyloroplasty is considered “gold” standard. Advances in therapeutic endoscopic intervention with gastric per-oral endoscopic pyloromyotomy have also been shown to improve gastric emptying and gastroparesis (GP) symptoms. In this review, we will comment on the challenges encountered when managing patients with DMGP and provide an update on advances in drug development and endoscopic and surgical interventions. Keywords: bloating, fullness, nausea, vomiting, Enterra, diabetes |
| first_indexed | 2024-12-22T20:13:23Z |
| format | Article |
| id | doaj.art-c36641bf1e7e460db901bbba280303cc |
| institution | Directory Open Access Journal |
| issn | 1178-7023 |
| language | English |
| last_indexed | 2024-12-22T20:13:23Z |
| publishDate | 2018-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical and Experimental Gastroenterology |
| spelling | doaj.art-c36641bf1e7e460db901bbba280303cc2022-12-21T18:14:02ZengDove Medical PressClinical and Experimental Gastroenterology1178-70232018-09-01Volume 1134736340864Diabetic gastroparesis: current challenges and future prospectsAvalos DJSarosiek ILoganathan PMcCallum RWDanny J Avalos,1 Irene Sarosiek,1 Priyadarshini Loganathan,2 Richard W McCallum1 1Division of Gastroenterology, Center for Neurogastroenterology and GI Motility, Texas Tech University Health Sciences Center, El Paso, TX, USA; 2Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA Abstract: Diabetic gastroparesis (DMGP) is a condition of delayed gastric emptying after gastric outlet obstruction has been excluded. Symptoms of nausea, vomiting, early satiety, bloating, and abdominal pain are associated with DMGP. Uncontrolled symptoms can lead to overall poor quality of life and financial burdens on the healthcare system. A combination of antiemetics and prokinetics is used in symptom control; metoclopramide is the main prokinetic available for clinical use and is the only U.S. Food and Drug Administration-approved agent in the United States. However, a black box warning in 2009 reporting its association with tardive dyskinesia and recommending caution in chronically using this agent beyond 3 months has decreased its role in clinical practice. There is an unmet need for new prokinetics with good efficacy and safety profiles. Currently, there are several new drugs with different mechanisms of action in the pipeline that are under investigation and show promising preliminary results. Surgically combining gastric electrical stimulation with pyloroplasty is considered “gold” standard. Advances in therapeutic endoscopic intervention with gastric per-oral endoscopic pyloromyotomy have also been shown to improve gastric emptying and gastroparesis (GP) symptoms. In this review, we will comment on the challenges encountered when managing patients with DMGP and provide an update on advances in drug development and endoscopic and surgical interventions. Keywords: bloating, fullness, nausea, vomiting, Enterra, diabeteshttps://www.dovepress.com/diabetic-gastroparesis-current-challenges-and-future-prospects-peer-reviewed-article-CEGdiabetic gastroparesisprokineticsantiemeticsgastric emptyinggastroparesis cardinal symptom index |
| spellingShingle | Avalos DJ Sarosiek I Loganathan P McCallum RW Diabetic gastroparesis: current challenges and future prospects Clinical and Experimental Gastroenterology diabetic gastroparesis prokinetics antiemetics gastric emptying gastroparesis cardinal symptom index |
| title | Diabetic gastroparesis: current challenges and future prospects |
| title_full | Diabetic gastroparesis: current challenges and future prospects |
| title_fullStr | Diabetic gastroparesis: current challenges and future prospects |
| title_full_unstemmed | Diabetic gastroparesis: current challenges and future prospects |
| title_short | Diabetic gastroparesis: current challenges and future prospects |
| title_sort | diabetic gastroparesis current challenges and future prospects |
| topic | diabetic gastroparesis prokinetics antiemetics gastric emptying gastroparesis cardinal symptom index |
| url | https://www.dovepress.com/diabetic-gastroparesis-current-challenges-and-future-prospects-peer-reviewed-article-CEG |
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