Navas Christopher M, Patel Nihal K, Lacy Brian E
Division of Gastroenterology and Hepatology, 1 Medical Center Drive, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA.
Dig Dis Sci. 2017 Sep;62(9):2231-2240. doi: 10.1007/s10620-017-4679-7. Epub 2017 Jul 18.
Gastroparesis is a chronic, bothersome, and often disabling neuromuscular disorder of the upper gastrointestinal tract. The most frequently reported symptoms of gastroparesis include nausea, vomiting, epigastric pain, early satiety, and unintentional weight loss. Etiologies of gastroparesis include diabetes, connective tissue disorders, prior infection, mesenteric ischemia, and post-surgical complications. The largest category of gastroparesis patients is comprised of those in whom no definitive cause can be identified (idiopathic gastroparesis). The individual and societal burden of gastroparesis is substantial. It considerably reduces patients' quality of life accompanied by a significant negative impact to the healthcare system. The current treatments of gastroparesis are less than ideal. Dietary modification may improve symptoms in patients with mild disease. Metoclopramide is the only medication currently approved for the treatment of gastroparesis; however, it is associated with adverse effects in a sizable proportion of patients. Other medications are frequently employed to treat symptoms of nausea and vomiting, although technically all are used off-label since they are not FDA approved for the treatment of gastroparesis. These data highlight the need to identify novel, more effective treatment options for this disabling disease. This review will provide a brief synopsis on the epidemiology, etiology, and impact of gastroparesis, discussing new therapeutic advances.
胃轻瘫是一种慢性、令人困扰且常导致功能障碍的上消化道神经肌肉疾病。胃轻瘫最常报告的症状包括恶心、呕吐、上腹部疼痛、早饱感和非刻意体重减轻。胃轻瘫的病因包括糖尿病、结缔组织疾病、既往感染、肠系膜缺血和术后并发症。胃轻瘫患者中最大的类别是那些无法确定明确病因的患者（特发性胃轻瘫）。胃轻瘫给个人和社会带来的负担很大。它极大地降低了患者的生活质量，同时对医疗系统产生重大负面影响。目前胃轻瘫的治疗并不理想。饮食调整可能会改善轻度疾病患者的症状。甲氧氯普胺是目前唯一被批准用于治疗胃轻瘫的药物；然而，相当一部分患者会出现不良反应。其他药物也经常用于治疗恶心和呕吐症状，尽管严格来说所有这些药物都是超适应症使用，因为它们未被美国食品药品监督管理局批准用于治疗胃轻瘫。这些数据凸显了为这种致残性疾病确定新的、更有效治疗方案的必要性。本综述将简要概述胃轻瘫的流行病学、病因和影响，并讨论新的治疗进展。
