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Gastroparesis and functional dyspepsia: spectrum of gastroduodenal neuromuscular disorders or unique entities?

  • Hiroki Sato
    Affiliations
    Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

    Division of Gastroenterology & Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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  • Madhusudan Grover
    Correspondence
    Correspondence: Madhusudan Grover, M.D. Associate Professor of Medicine, Physiology & Biomedical Engineering, Division of Gastroenterology and Hepatology, Enteric Neuroscience Program, Mayo clinic, 200 First St SW, Rochester, MN 55905, USA. Phone: 507-284-2478;
    Affiliations
    Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
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Open AccessPublished:October 13, 2022DOI:https://doi.org/10.1016/j.gastha.2022.10.005
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      Abstract

      Gastroparesis is defined by delayed gastric emptying in the absence of mechanical obstruction of the stomach. Patients experience symptoms of nausea, vomiting, abdominal pain, fullness and early satiety. The recognition of the disorder has progressed due to availability of gastric emptying scintigraphy and advancements made in understanding its pathophysiology and treatment options. The clinical presentation and treatment of gastroparesis overlaps with a more commonly recognized disorder of gut-brain interaction, functional dyspepsia. Recent studies have reenergized the discussion whether these two are separate entities or perhaps reflect a spectrum of gastroduodenal neuromuscular disorders. The societal guidelines conflict on the utility of gastric emptying scintigraphy in assessment of patients with upper gastrointestinal symptoms. A better appraisal of similarities and differences between gastroparesis and functional dyspepsia will allow targeted treatment for these disorders. This is particularly important as specific pharmacological and endoscopic treatment options are being developed for gastroparesis which are unlikely to be helpful for funcational dyspepsia. This review makes the case for considering these disorders in a spectrum where identification of both would most ideally position us towards providing the optimal clinical care.

      Keywords