Severe gastroparesis: new treatment alternatives |
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| Authors: | Abrahamsson Hasse |
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| Institution: | 1. Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands;2. Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands;3. Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands;4. Emerging Pathogens Institute and Animal Sciences Department, University of Florida, Gainesville, FL, United States;5. Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands;1. Department of Radiopharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran;2. Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Department of Pharmaceutical Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran;4. Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran;1. Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology — BIPS, Achterstr. 30, 28359 Bremen, Germany;2. Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology — BIPS, Achterstr. 30, 28359 Bremen, Germany;3. Research Centre in Epidemiology and Preventive Medicine — EPIMED, Department of Clinical and Experimental Medicine, University of Insubria, Via O Rossi 9, 21100 Varese, Italy;4. Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Via dell''Elettronica, 86077 Pozzilli, Italy;5. Department of Chronic Diseases, Centre of Behavioural and Health Sciences, National Institute for Health Development, Hiiu St 42, 11619 Tallinn, Estonia;6. Department of Public Health and Community Medicine, University of Gothenburg, Medicinaregatan 16, 40530 Gothenburg, Sweden;7. Department of Paediatrics, Queen Silvia Children''s Hospital, University of Gothenburg, Rondvägen 10, SE 41686 Gothenburg, Sweden;8. Department of Pediatrics, University of Pécs, József A. u. 7, 7623 Pécs, Hungary;9. GENUD (Growth, Exercise, Nutrition and Development) Research Group, University School of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;10. Institute of Food Sciences, National Research Council, Via Roma 64, 83100 Avellino, Italy;11. Department of Public Health, Ghent University, UZ 2 Blok A De Pintelaan 185, 9000 Ghent, Belgium;12. Faculty of Mathematics and Computer Science, Bremen University, Bibliothekstr. 1, 28359 Bremen, Germany |
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| Abstract: | Dopamine antagonists, such as metoclopramide and domperidone, and the motilin receptor agonist erythromycin have been the cornerstones in drug treatment of severe gastroparesis for more than a decade. No new drugs have been approved for treatment of this disorder in this period. Instead, the 5-HT4 agonist cisapride has been withdrawn due to side-effects. The effectiveness of intrapyloric botulinum toxin for gastroparesis remains to be shown. In the last decade, gastric electrical stimulation (GES) with a fully implantable device has evolved as a promising treatment, with significant effects on nausea and vomiting in most patients with severe, drug-refractory diabetic gastroparesis and postsurgical gastroparesis. A proportion of patients with severe idiopathic gastroparesis and patients with idiopathic nausea and vomiting also respond. More research is needed to achieve precise selection of responders/non-responders to GES, and to study the potential benefit of GES in other patient groups suffering from severe nausea or vomiting. |
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