Display options
Cite
Stein B, Everhart KK, Lacy BE. Treatment of functional dyspepsia and gastroparesis. Curr Treat Options Gastroenterol. 2014;12(4):385-97doi: 10.1007/s11938-014-0028-5.
Stein, B., Everhart, K. K., & Lacy, B. E. (2014). Treatment of functional dyspepsia and gastroparesis. Current treatment options in gastroenterology, 12(4), 385-97. https://doi.org/10.1007/s11938-014-0028-5
Stein, Benjamin, et al. "Treatment of functional dyspepsia and gastroparesis." Current treatment options in gastroenterology vol. 12,4 (2014): 385-97. doi: https://doi.org/10.1007/s11938-014-0028-5
Stein B, Everhart KK, Lacy BE. Treatment of functional dyspepsia and gastroparesis. Curr Treat Options Gastroenterol. 2014 Dec;12(4):385-97. doi: 10.1007/s11938-014-0028-5. PMID: 25169218.
Copy Download .nbib Format: NLM
Share it on

Curr Treat Options Gastroenterol. 2014 Dec;12(4):385-97. doi: 10.1007/s11938-014-0028-5.

Treatment of functional dyspepsia and gastroparesis.

Current treatment options in gastroenterology

Benjamin Stein, Kelley K Everhart, Brian E Lacy

Affiliations

  1. Division of Gastroenterology & Hepatology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA, [email protected].

PMID: 25169218 DOI: 10.1007/s11938-014-0028-5

Abstract

OPINION STATEMENT: Functional dyspepsia (FD) and gastroparesis (GP) are the two most prevalent gastric neuromuscular disorders. These disorders are frequently confused, have more similarities than differences, and can be thought of as two ends of a continuous spectrum of gastric neuromuscular disorders (Fig. 1). FD is currently defined by the Rome III criteria; it is now subdivided into a pain-predominant subtype (epigastric pain syndrome) and a meal-associated subtype (post-prandial distress syndrome). GP is defined by symptoms in conjunction with delayed gastric emptying in the absence of mechanical obstruction. Symptoms for both FD and GP are similar and include epigastric pain or discomfort, early satiety, bloating, and post-prandial nausea. Vomiting can occur with either diagnosis; it is typically more common in GP. A patient suspected of having either FD or GP should undergo upper endoscopy. In suspected FD, upper endoscopy is required to exclude an alternative organic cause for the patient's symptoms; however, most (70 %) patients with dyspeptic symptoms will have FD rather than an organic disorder. In suspected GP, upper endoscopy is required to rule out a mechanical obstruction. A 4-hour solid-phase gastric emptying scan is recommended to confirm the diagnosis of GP; its utility is unclear in patients with FD, as it may not change treatment. Once the diagnosis of FD or GP is made, treatment should focus on the predominant symptom. This is especially true in patients with GP, as accelerating gastric emptying with the use of prokinetics may not necessarily translate into an improvement in symptoms. Unfortunately, no medication is currently approved for the treatment of FD and, thus, technically, all treatment options remain off-label, including medications for visceral pain (e.g., tricyclic antidepressants) and nausea. This review focuses on treatment options for FD and GP with an emphasis on new advances in the field over the last several years.

References

  1. Digestion. 2003;67(4):209-17 - PubMed
  2. Am J Gastroenterol. 2007 Sep;102(9):1983-9 - PubMed
  3. Clin Gastroenterol Hepatol. 2010 Jun;8(6):498-503 - PubMed
  4. Aliment Pharmacol Ther. 2001 Apr;15(4):525-37 - PubMed
  5. Gastroenterology. 2006 Apr;130(5):1466-79 - PubMed
  6. Am J Gastroenterol. 2008 Feb;103(2):416-23 - PubMed
  7. Clin Ther. 1998 May-Jun;20(3):438-53 - PubMed
  8. Aliment Pharmacol Ther. 2013 Jul;38(2):170-7 - PubMed
  9. Am J Gastroenterol. 2013 Jan;108(1):18-37; quiz 38 - PubMed
  10. Am J Gastroenterol. 2003 Feb;98(2):259-63 - PubMed
  11. Ital J Gastroenterol. 1996 Jul-Aug;28(6):317-23 - PubMed
  12. Aliment Pharmacol Ther. 2007 Nov 1;26(9):1251-8 - PubMed
  13. Eur J Nucl Med. 1991;18(4):229-34 - PubMed
  14. Gastrointest Endosc. 1998 Jan;47(1):67-70 - PubMed
  15. Gut. 2008 Jun;57(6):740-6 - PubMed
  16. Neurogastroenterol Motil. 2012 Jun;24(6):540-5, e250-1 - PubMed
  17. Aliment Pharmacol Ther. 2013 Jun;37(11):1074-83 - PubMed
  18. Neurogastroenterol Motil. 2014 Apr;26(4):521-8 - PubMed
  19. Z Gastroenterol. 1994 Nov;32(11):637-41 - PubMed
  20. JAMA. 2013 Dec 25;310(24):2640-9 - PubMed
  21. J Gastrointest Surg. 2011 Sep;15(9):1513-9 - PubMed
  22. Dig Dis Sci. 2002 Dec;47(12):2664-8 - PubMed
  23. J Gastroenterol. 2013 Feb;48(2):177-81 - PubMed
  24. Diabetes Care. 1983 Sep-Oct;6(5):463-7 - PubMed
  25. Diabetologia. 1989 Mar;32(3):151-9 - PubMed
  26. Forsch Komplementmed. 2013;20 Suppl 2:2-7 - PubMed
  27. Diabetes Care. 1998 Oct;21(10):1699-706 - PubMed
  28. Pediatr Infect Dis J. 2013 Sep;32(9):1042-3 - PubMed
  29. Am J Gastroenterol. 1996 Oct;91(10):2174-8 - PubMed
  30. Clin Gastroenterol Hepatol. 2008 Jul;6(7):746-52; quiz 718 - PubMed
  31. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD001960 - PubMed
  32. J Clin Gastroenterol. 2014 Mar;48(3):241-7 - PubMed
  33. Clin Exp Allergy. 2007 Jun;37(6):823-30 - PubMed
  34. Dig Dis Sci. 1998 Nov;43(11):2398-404 - PubMed
  35. Ann Intern Med. 1982 Apr;96(4):444-6 - PubMed
  36. Arch Intern Med. 2000 Oct 9;160(18):2808-16 - PubMed
  37. Gastroenterology. 1999 Mar;116(3):515-20 - PubMed
  38. Arch Intern Med. 2001 Sep 10;161(16):1989-96 - PubMed
  39. Eur Rev Med Pharmacol Sci. 2013;17(15):2085-90 - PubMed
  40. Am J Gastroenterol. 1999 Apr;94(4):1029-33 - PubMed
  41. Arch Intern Med. 1993 Jun 28;153(12):1469-75 - PubMed
  42. Clin Gastroenterol Hepatol. 2009 Mar;7(3):317-22 - PubMed
  43. Gastroenterology. 2004 Nov;127(5):1589-91 - PubMed
  44. Aliment Pharmacol Ther. 2011 Sep;34(6):638-48 - PubMed
  45. Dig Dis Sci. 1979 Sep;24(9):662-6 - PubMed
  46. Nat Rev Gastroenterol Hepatol. 2013 Mar;10(3):187-94 - PubMed
  47. Am J Gastroenterol. 2013 May;108(5):728-36 - PubMed
  48. Am J Gastroenterol. 2012 May;107(5):657-66; quiz 667 - PubMed
  49. Aliment Pharmacol Ther. 2003 Aug 15;18(4):387-93 - PubMed
  50. J Gastroenterol Hepatol. 2012 Jun;27(6):1017-26 - PubMed
  51. Gastroenterology. 2005 Nov;129(5):1756-80 - PubMed
  52. J Gastroenterol Hepatol. 2007 Oct;22(10):1566-70 - PubMed
  53. Qual Life Res. 2004 May;13(4):833-44 - PubMed
  54. Am J Gastroenterol. 1987 Jan;82(1):29-35 - PubMed
  55. Neurogastroenterol Motil. 2009 Mar;21(3):272-80 - PubMed
  56. J Clin Gastroenterol. 1985 Feb;7(1):25-32 - PubMed
  57. Evid Based Complement Alternat Med. 2012;2012:936459 - PubMed
  58. Dig Dis Sci. 2010 Jan;55(1):60-5 - PubMed
  59. Am J Gastroenterol. 2008 Aug;103(8):1906-19 - PubMed
  60. South Med J. 2002 Nov;95(11):1297-9 - PubMed
  61. Am J Gastroenterol. 2004 Jan;99(1):170-81 - PubMed
  62. Clin Gastroenterol Hepatol. 2007 Feb;5(2):178-85; quiz 140 - PubMed
  63. Am J Gastroenterol. 1999 May;94(5):1230-4 - PubMed
  64. Clin Gastroenterol Hepatol. 2012 Nov;10(11):1239-45 - PubMed
  65. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD002096 - PubMed
  66. Scand J Gastroenterol. 1995 Jun;30(6):531-4 - PubMed
  67. Contemp Clin Trials. 2012 May;33(3):523-33 - PubMed
  68. Am J Gastroenterol. 2013 Jun;108(6):866-72 - PubMed
  69. Gut. 2012 Jun;61(6):821-8 - PubMed
  70. Am J Gastroenterol. 2008 Aug;103(8):2043-50 - PubMed
  71. Am J Gastroenterol. 2013 May;108(5):737-47 - PubMed
  72. J Am Coll Surg. 2014 Apr;218(4):652-60 - PubMed
  73. Gut. 2005 Oct;54(10):1370-6 - PubMed
  74. Dig Dis Sci. 2007 Feb;52(2):418-24 - PubMed
  75. Am J Gastroenterol. 2008 Feb;103(2):313-22 - PubMed
  76. Diabetes Care. 2001 Jul;24(7):1264-9 - PubMed
  77. Clin Gastroenterol Hepatol. 2013 Nov;11(11):1453-1459.e4 - PubMed
  78. J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:53-60 - PubMed
  79. Clin Gastroenterol Hepatol. 2015 Mar;13(3):422-32 - PubMed
  80. Nat Rev Gastroenterol Hepatol. 2013 Mar;10(3):175-86 - PubMed
  81. Neurogastroenterol Motil. 2006 Aug;18(8):608-18 - PubMed
  82. JAMA. 2008 Feb 6;299(5):555-65 - PubMed
  83. Gut. 2008 Nov;57(11):1495-503 - PubMed
  84. Gut. 2003 Oct;52(10):1414-8 - PubMed
  85. Gastroenterology. 2004 Oct;127(4):1239-55 - PubMed
  86. Am J Gastroenterol. 2012 Nov;107(11):1615-20 - PubMed
  87. Aliment Pharmacol Ther. 2012 Jul;36(1):3-15 - PubMed
  88. Clin Gastroenterol Hepatol. 2004 Nov;2(11):985-96 - PubMed
  89. Aliment Pharmacol Ther. 2004 Mar 15;19(6):643-54 - PubMed
  90. Am J Gastroenterol. 1997 Jun;92(6):976-80 - PubMed
  91. Neurogastroenterol Motil. 2006 Aug;18(8):595-607 - PubMed

Publication Types