Gastroparesis Awareness Month: Guideline updates, diabetic GP, G-POEM
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Healio handpicked a series of stories on gastroparesis to raise awareness and increase education during Gastroparesis Awareness Month.
ACG updates gastroparesis guidelines for diagnosis, treatment amid ‘ongoing innovation’
The American College of Gastroenterology has issued a new guideline for the diagnosis and management of gastroparesis, which recently was published in The American Journal of Gastroenterology.
“The objective of this new guideline is to document, summarize and update the evidence and develop recommendations for the clinical management of gastroparesis (GP),” Michael Camilleri, MD, DSc, MRCP, MACG, AGAF, professor of gastroenterology and hepatology at Mayo Clinic in Rochester, Minnesota, and colleagues wrote. “It is necessary to acknowledge the limitations of guideline recommendations on therapies in the absence of FDA-approved therapies for GP in the United States and the limitation in duration of prescription to 3 months for the only currently approved medication, metoclopramide.” Read more.
Peripheral neuropathy common in patients with idiopathic, diabetic gastroparesis
Patients with symptoms of gastroparesis — including those with diabetic and idiopathic etiologies — demonstrated a prevalence for peripheral neuropathy, according to a study published in BMC Gastroenterology.
Researchers further reported that, particularly in patients with idiopathic gastroparesis, this prevalence was associated with more severe gastroparetic symptoms compared with patients with gastroparesis and no peripheral neuropathy. Read more.
Degree of pyloric dysfunction may impact Botox injection in gastroparesis symptom response
Among patients with gastroparesis, pyloric botulinum toxin may be effective in those with lesser pyloric impairments. However, those with worse pyloric dysfunction may not benefit, according to a presentation the ACG Annual Scientific Meeting.
“Pyloric botulinum toxin injection improved nausea and vomiting and elicited trends to reduced overall gastroparesis symptoms at 6 weeks,” Lydia S. Watts, BS, of Michigan Medicine at the University of Michigan in Ann Arbor, said. “Exploratory EndoFLIP (Medtronic) analyses defined cutoffs for pyloric diameter and distensibility. Read more.
G-POEM improves gastroparesis symptoms, gastric emptying
Endoscopic pyloromyotomy, also known as gastric peroral endoscopic myotomy, bested sham procedure in symptom improvement and gastric emptying among patients with severe and refractory gastroparesis, according to a presenter at UEG Week.
“Gastroparesis is defined by the delayed gastric emptying in the absence of mechanical obstruction,” Rastislav Hustak, MD, of the Institute for Clinical and Experimental Medicine in Prague and University Hospital Trnava in Slovakia, said. “Pylorospasm may play a role in the development of gastroparesis, and limited data has demonstrated some effectiveness of pylorus-directed therapies. ... Gastric peroral endoscopic myotomy (G-POEM) is a relatively new and promising procedure, but its effectiveness has not been proven.” Read more.
Gastroparesis shows loss of pain sensation, increased pain-related worry
Implementing quantitative sensory testing for patients with gastroparesis showed less sensation in idiopathic cases vs. diabetic gastroparesis, but both phenotypes had increased concern about pain, according to a presentation at Digestive Disease Week.
“We found that idiopathic gastroparesis was associated with an abnormal somatic peripheral loss of protective sensation to the noxious stimulation,” Helen Burton Murray, PhD, of Massachusetts General Hospital, said in her presentation on behalf of the NIH/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Gastroparesis Clinical and Research Consortium. “Twenty one percent screened positively for having a likely neuropathic pain and 46% screened positively for having significant pain-related worry.” Read more.
Q&A: Spreading awareness during gastroparesis awareness month
Gastroparesis, a chronic and long-term gastrointestinal disorder, is estimated to burden 5 million individuals in the United States with crippling symptoms of delayed gastric emptying.
“Gastroparesis (GP) can be extremely debilitating and life threatening,” Ceciel T. Rooker, president of the International Foundation for GI Disorders (IFFGD) said in IFFGD’s 2021 media toolkit. “Many patients suffer without others knowing what they are battling internally every single day.” Read more.