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Digestive Disease Interventions 2021; 05(02): 186-193
DOI: 10.1055/s-0041-1728715
Special Communication

Endoscopic Management of Gastroparesis

Kevin Seeras 
1   Department of Surgery, Stony Brook Medicine, Stony Brook, New York
,
Salvatore Docimo Jr.
1   Department of Surgery, Stony Brook Medicine, Stony Brook, New York
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Abstract

Gastroparesis is a complex pathology that continues to evolve in its diagnosis and treatment. Throughout the years, we have gained a more thorough understanding of normal and pathologic physiology of the stomach, which has allowed us to garner different approaches to the treatment of gastroparesis. We aim to evaluate the current literature regarding diagnosis and treatment of gastroparesis with a specific focus on the endoscopic management of this pathology.

Keywords

gastroparesis - management of gastroparesis - endoscopic management


Publication History

Received: 12 January 2021

Accepted: 03 March 2021

Article published online:
06 May 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Schemann M, Rohn M, Michel K. Motor control of the stomach. Eur Rev Med Pharmacol Sci 2008; 12 (Suppl. 01) 41-51
    PubMedGoogle Scholar
  • 2 Jung HK, Choung RS, Locke III GR. et al. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology 2009; 136 (04) 1225-1233
    CrossrefPubMedGoogle Scholar
  • 3 Soykan I, Sivri B, Sarosiek I, Kiernan B, McCallum RW. Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis. Dig Dis Sci 1998; 43 (11) 2398-2404
    CrossrefPubMedGoogle Scholar
  • 4 Kassander P. Asymptomatic gastric retention in diabetics (gastroparesis diabeticorum). Ann Intern Med 1958; 48 (04) 797-812
    CrossrefPubMedGoogle Scholar
  • 5 Parkman HP, Yates K, Hasler WL. et al; National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium. Clinical features of idiopathic gastroparesis vary with sex, body mass, symptom onset, delay in gastric emptying, and gastroparesis severity. Gastroenterology 2011; 140 (01) 101-115
    CrossrefPubMedGoogle Scholar
  • 6 Hasler WL, Wilson LA, Parkman HP. et al; NIDDK Gastroparesis Clinical Research Consortium (GpCRC). Bloating in gastroparesis: severity, impact, and associated factors. Am J Gastroenterol 2011; 106 (08) 1492-1502
    CrossrefPubMedGoogle Scholar
  • 7 Choi KM, Gibbons SJ, Nguyen TV. et al. Heme oxygenase-1 protects interstitial cells of Cajal from oxidative stress and reverses diabetic gastroparesis. Gastroenterology 2008; 135 (06) 2055-2064 , 2064.e1–2064.e2
    CrossrefPubMedGoogle Scholar
  • 8 Camilleri M, Chedid V, Ford AC. et al. Gastroparesis. Nat Rev Dis Primers 2018; 4 (01) 41
    Google Scholar
  • 9 Hasler WL. Gastroparesis: pathogenesis, diagnosis and management. Nat Rev Gastroenterol Hepatol 2011; 8 (08) 438-453
    CrossrefPubMedGoogle Scholar
  • 10 Abell TL, Camilleri M, Donohoe K. et al; American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. Am J Gastroenterol 2008; 103 (03) 753-763
    CrossrefPubMedGoogle Scholar
  • 11 Ghoos YF, Maes BD, Geypens BJ. et al. Measurement of gastric emptying rate of solids by means of a carbon-labeled octanoic acid breath test. Gastroenterology 1993; 104 (06) 1640-1647
    CrossrefPubMedGoogle Scholar
  • 12 Szarka LA, Camilleri M, Vella A. et al. A stable isotope breath test with a standard meal for abnormal gastric emptying of solids in the clinic and in research. Clin Gastroenterol Hepatol 2008; 6 (06) 635-643.e1
    CrossrefPubMedGoogle Scholar
  • 13 Shin AS, Camilleri M. Diagnostic assessment of diabetic gastroparesis. Diabetes 2013; 62 (08) 2667-2673
    CrossrefPubMedGoogle Scholar
  • 14 Kunkel DC, Clarke JO. Murky waters for diagnosis of gastroparesis. Clin Gastroenterol Hepatol 2019; 17 (09) 1724-1725
    CrossrefPubMedGoogle Scholar
  • 15 Lee AA, Rao S, Nguyen LA. et al. Validation of diagnostic and performance characteristics of the wireless motility capsule in patients with suspected gastroparesis. Clin Gastroenterol Hepatol 2019; 17 (09) 1770-1779.e2
    CrossrefPubMedGoogle Scholar
  • 16 Camilleri M, Hasler WL, Parkman HP, Quigley EM, Soffer E. Measurement of gastrointestinal motility in the GI laboratory. Gastroenterology 1998; 115 (03) 747-762
    CrossrefPubMedGoogle Scholar
  • 17 Malik Z, Sankineni A, Parkman HP. Assessing pyloric sphincter pathophysiology using EndoFLIP in patients with gastroparesis. Neurogastroenterol Motil 2015; 27 (04) 524-531
    CrossrefPubMedGoogle Scholar
  • 18 Gourcerol G, Tissier F, Melchior C. et al. Impaired fasting pyloric compliance in gastroparesis and the therapeutic response to pyloric dilatation. Aliment Pharmacol Ther 2015; 41 (04) 360-367
    CrossrefPubMedGoogle Scholar
  • 19 Revicki DA, Rentz AM, Dubois D. et al. Development and validation of a patient-assessed gastroparesis symptom severity measure: the Gastroparesis Cardinal Symptom Index. Aliment Pharmacol Ther 2003; 18 (01) 141-150
    CrossrefPubMedGoogle Scholar
  • 20 Revicki DA, Camilleri M, Kuo B. et al. Development and content validity of a gastroparesis cardinal symptom index daily diary. Aliment Pharmacol Ther 2009; 30 (06) 670-680
    CrossrefPubMedGoogle Scholar
  • 21 Revicki DA, Rentz AM, Dubois D. et al. Gastroparesis Cardinal Symptom Index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res 2004; 13 (04) 833-844
    CrossrefPubMedGoogle Scholar
  • 22 Parrish CR, Yoshida CM. Nutrition intervention for the patient with gastroparesis: an update. Pract Gastroenterol 2005; 29: 29
    PubMedGoogle Scholar
  • 23 Sarosiek I, Davis B, Eichler E, McCallum RW. Surgical approaches to treatment of gastroparesis: gastric electrical stimulation, pyloroplasty, total gastrectomy and enteral feeding tubes. Gastroenterol Clin North Am 2015; 44 (01) 151-167
    CrossrefPubMedGoogle Scholar
  • 24 Bouras EP, Vazquez Roque MI, Aranda-Michel J. Gastroparesis: from concepts to management. Nutr Clin Pract 2013; 28 (04) 437-447
    CrossrefPubMedGoogle Scholar
  • 25 Wang CP, Kao CH, Chen WK, Lo WY, Hsieh CL. A single-blinded, randomized pilot study evaluating effects of electroacupuncture in diabetic patients with symptoms suggestive of gastroparesis. J Altern Complement Med 2008; 14 (07) 833-839
    CrossrefPubMedGoogle Scholar
  • 26 Kim KH, Lee MS, Choi TY, Kim TH. Acupuncture for symptomatic gastroparesis. Cochrane Database Syst Rev 2018; 12 (12) CD009676
    PubMedGoogle Scholar
  • 27 Gottfried-Blackmore A, Adler EP, Fernandez-Becker N, Clarke J, Habtezion A, Nguyen L. Open-label pilot study: non-invasive vagal nerve stimulation improves symptoms and gastric emptying in patients with idiopathic gastroparesis. Neurogastroenterol Motil 2020; 32 (04) e13769
    CrossrefPubMedGoogle Scholar
  • 28 Shada AL, Dunst CM, Pescarus R. et al. Laparoscopic pyloroplasty is a safe and effective first-line surgical therapy for refractory gastroparesis. Surg Endosc 2016; 30 (04) 1326-1332
    CrossrefPubMedGoogle Scholar
  • 29 Toro JP, Lytle NW, Patel AD. et al. Efficacy of laparoscopic pyloroplasty for the treatment of gastroparesis. J Am Coll Surg 2014; 218 (04) 652-660
    CrossrefPubMedGoogle Scholar
  • 30 Hibbard ML, Dunst CM, Swanström LL. Laparoscopic and endoscopic pyloroplasty for gastroparesis results in sustained symptom improvement. J Gastrointest Surg 2011; 15 (09) 1513-1519
    CrossrefPubMedGoogle Scholar
  • 31 Abell T, McCallum R, Hocking M. et al. Gastric electrical stimulation for medically refractory gastroparesis. Gastroenterology 2003; 125 (02) 421-428
    CrossrefPubMedGoogle Scholar
  • 32 Arthur LE, Slattery L, Richardson W. Tailored approach to gastroparesis significantly improves symptoms. Surg Endosc 2018; 32 (02) 977-982
    CrossrefPubMedGoogle Scholar
  • 33 de Csepel J, Goldfarb B, Shapsis A, Goff S, Gabriel N, Eng HM. Electrical stimulation for gastroparesis. Gastric motility restored. Surg Endosc 2006; 20 (02) 302-306
    CrossrefPubMedGoogle Scholar
  • 34 McCallum RW, Sarosiek I, Parkman HP. et al. Gastric electrical stimulation with Enterra therapy improves symptoms of idiopathic gastroparesis. Neurogastroenterol Motil 2013; 25 (10) 815-e636
    CrossrefPubMedGoogle Scholar
  • 35 Timratana P, El-Hayek K, Shimizu H, Kroh M, Chand B. Laparoscopic gastric electrical stimulation for medically refractory diabetic and idiopathic gastroparesis. J Gastrointest Surg 2013; 17 (03) 461-470
    CrossrefPubMedGoogle Scholar
  • 36 Davis BR, Sarosiek I, Bashashati M, Alvarado B, McCallum RW. The long-term efficacy and safety of pyloroplasty combined with gastric electrical stimulation therapy in gastroparesis. J Gastrointest Surg 2017; 21 (02) 222-227
    CrossrefPubMedGoogle Scholar
  • 37 Tetangco EGP, Harrell S, Abboud R. et al. GOO due to gastric stimulator electrode migration: add this to your DDx of gastroparesis exacerbation: 1890. Am J Gastroenterol 2018; 113: S1072-S1073
    CrossrefPubMedGoogle Scholar
  • 38 Abell TL, Johnson WD, Kedar A. et al. A double-masked, randomized, placebo-controlled trial of temporary endoscopic mucosal gastric electrical stimulation for gastroparesis. Gastrointest Endosc 2011; 74 (03) 496-503.e3
    CrossrefPubMedGoogle Scholar
  • 39 Deb S, Tang SJ, Abell TL. et al. An endoscopic wireless gastrostimulator (with video). Gastrointest Endosc 2012; 75 (02) 411-415 , 415.e1
    CrossrefPubMedGoogle Scholar
  • 40 Lee AM, Fuchs KH, Varga G. et al. Sleeve gastrectomy for treatment of delayed gastric emptying-indications, technique, and results. Langenbecks Arch Surg 2020; 405 (01) 107-116
    CrossrefPubMedGoogle Scholar
  • 41 Landreneau JP, Strong AT, El-Hayek K, Kroh MD, Rodriguez JH. Gastrectomy versus stomach left in situ with Roux-en-Y reconstruction for the treatment of gastroparesis. Surg Endosc 2020; 34 (04) 1847-1855
    CrossrefPubMedGoogle Scholar
  • 42 Wiesel PH, Schneider R, Dorta G, Blum AL, Gillet M, Michetti P. Botulinum toxin for refractory postoperative pyloric spasm. Endoscopy 1997; 29 (02) 132
    Article in Thieme ConnectPubMedGoogle Scholar
  • 43 Miller LS, Szych GA, Kantor SB. et al. Treatment of idiopathic gastroparesis with injection of botulinum toxin into the pyloric sphincter muscle. Am J Gastroenterol 2002; 97 (07) 1653-1660
    CrossrefPubMedGoogle Scholar
  • 44 Lacy BE, Zayat EN, Crowell MD, Schuster MM. Botulinum toxin for the treatment of gastroparesis: a preliminary report. Am J Gastroenterol 2002; 97 (06) 1548-1552
    CrossrefPubMedGoogle Scholar
  • 45 Arts J, van Gool S, Caenepeel P, Verbeke K, Janssens J, Tack J. Influence of intrapyloric botulinum toxin injection on gastric emptying and meal-related symptoms in gastroparesis patients. Aliment Pharmacol Ther 2006; 24 (04) 661-667
    CrossrefPubMedGoogle Scholar
  • 46 Bromer MQ, Friedenberg F, Miller LS, Fisher RS, Swartz K, Parkman HP. Endoscopic pyloric injection of botulinum toxin A for the treatment of refractory gastroparesis. Gastrointest Endosc 2005; 61 (07) 833-839
    CrossrefPubMedGoogle Scholar
  • 47 Gupta P, Rao SS. Attenuation of isolated pyloric pressure waves in gastroparesis in response to botulinum toxin injection: a case report. Gastrointest Endosc 2002; 56 (05) 770-772
    CrossrefPubMedGoogle Scholar
  • 48 Arts J, Holvoet L, Caenepeel P. et al. Clinical trial: a randomized-controlled crossover study of intrapyloric injection of botulinum toxin in gastroparesis. Aliment Pharmacol Ther 2007; 26 (09) 1251-1258
    CrossrefPubMedGoogle Scholar
  • 49 Friedenberg FK, Palit A, Parkman HP, Hanlon A, Nelson DB. Botulinum toxin A for the treatment of delayed gastric emptying. Am J Gastroenterol 2008; 103 (02) 416-423
    CrossrefPubMedGoogle Scholar
  • 50 Bai Y, Xu MJ, Yang X. et al. A systematic review on intrapyloric botulinum toxin injection for gastroparesis. Digestion 2010; 81 (01) 27-34
    CrossrefPubMedGoogle Scholar
  • 51 Clarke JO, Sharaiha RZ, Kord Valeshabad A, Lee LA, Kalloo AN, Khashab MA. Through-the-scope transpyloric stent placement improves symptoms and gastric emptying in patients with gastroparesis. Endoscopy 2013; 45 (Suppl 2 UCTN): E189-E190
    Article in Thieme ConnectPubMedGoogle Scholar
  • 52 Khashab MA, Besharati S, Ngamruengphong S. et al. Refractory gastroparesis can be successfully managed with endoscopic transpyloric stent placement and fixation (with video). Gastrointest Endosc 2015; 82 (06) 1106-1109
    CrossrefPubMedGoogle Scholar
  • 53 Khashab MA, Stein E, Clarke JO. et al. Gastric peroral endoscopic myotomy for refractory gastroparesis: first human endoscopic pyloromyotomy (with video). Gastrointest Endosc 2013; 78 (05) 764-768
    CrossrefPubMedGoogle Scholar
  • 54 Khashab MA, Ngamruengphong S, Carr-Locke D. et al. Gastric per-oral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video). Gastrointest Endosc 2017; 85 (01) 123-128
    CrossrefPubMedGoogle Scholar
  • 55 Mekaroonkamol P, Shah R, Cai Q. Outcomes of per oral endoscopic pyloromyotomy in gastroparesis worldwide. World J Gastroenterol 2019; 25 (08) 909-922
    CrossrefPubMedGoogle Scholar
  • 56 Spadaccini M, Maselli R, Chandrasekar VT. et al. Gastric peroral endoscopic pyloromyotomy for refractory gastroparesis: a systematic review of early outcomes with pooled analysis. Gastrointest Endosc 2020; 91 (04) 746-752.e5
    CrossrefPubMedGoogle Scholar
  • 57 Mohan BP, Chandan S, Jha LK. et al. Clinical efficacy of gastric per-oral endoscopic myotomy (G-POEM) in the treatment of refractory gastroparesis and predictors of outcomes: a systematic review and meta-analysis using surgical pyloroplasty as a comparator group. Surg Endosc 2019
    Google Scholar
  • 58 Aghaie Meybodi M, Qumseya BJ, Shakoor D. et al. Efficacy and feasibility of G-POEM in management of patients with refractory gastroparesis: a systematic review and meta-analysis. Endosc Int Open 2019; 7 (03) E322-E329
    Article in Thieme ConnectPubMedGoogle Scholar
  • 59 Uemura KL, Chaves D, Bernardo WM, Uemura RS, de Moura DTH, de Moura EGH. Peroral endoscopic pyloromyotomy for gastroparesis: a systematic review and meta-analysis. Endosc Int Open 2020; 8 (07) E911-E923
    Article in Thieme ConnectPubMedGoogle Scholar
  • 60 Gonzalez JM, Benezech A, Vitton V, Barthet M. G-POEM with antro-pyloromyotomy for the treatment of refractory gastroparesis: mid-term follow-up and factors predicting outcome. Aliment Pharmacol Ther 2017; 46 (03) 364-370
    CrossrefPubMedGoogle Scholar
  • 61 Brown AM, Pryor AD, Docimo Jr S. Per oral pyloromyotomy utilizing a lesser curvature approach: how we do it. Surg Endosc 2020; 34 (11) 5168-5171
    CrossrefPubMedGoogle Scholar