Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville, Louisville, KY, USA.
Gut Liver. 2017 Sep 15;11(5):579-589. doi: 10.5009/gnl16336.
Gastroparesis (Gp) is a chronic disease that presents with clinical symptoms of early satiety, bloating, nausea, vomiting, and abdominal pain. Along with these symptoms, an objective finding of delayed gastric emptying, along with a documented absence of gastric outlet obstruction, are required for diagnosis. This article focuses on updates in the pathogenesis and management of Gp. Recent studies on full thickness biopsies of Gp patients have shed light on the complex interactions of the central, autonomic, and enteric nervous systems, which all play key roles in maintaining normal gut motility. The management of Gp has evolved beyond prokinetics and antiemetics with the use of gastric electrical stimulators (GES). In addition, this review aims to introduce the concept of gastroparesis-like syndrome (GLS). GLS helps groups of patients who have the cardinal symptoms of Gp but have a normal or rapid emptying test. Recent tests have shown that patients with Gp and GLS have similar pathophysiology, benefit greatly from GES placement, and likely should be treated in a similar manner.
胃轻瘫（Gp）是一种慢性疾病，其临床症状为早饱、腹胀、恶心、呕吐和腹痛。除了这些症状外，还需要有客观的胃排空延迟发现，并排除胃出口梗阻，才能做出诊断。本文重点介绍了 Gp 的发病机制和治疗的最新进展。最近对 Gp 患者全层活检的研究揭示了中枢、自主和肠神经系统之间复杂的相互作用，这些系统在维持正常肠道运动方面都起着关键作用。Gp 的治疗已经超越了促动力药和止吐药，开始使用胃电刺激器（GES）。此外，本综述旨在介绍胃轻瘫样综合征（GLS）的概念。GLS 适用于具有 Gp 主要症状但排空试验正常或快速的患者群体。最近的研究表明，患有 Gp 和 GLS 的患者具有相似的病理生理学，从 GES 植入中获益巨大，可能需要以类似的方式进行治疗。
