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Gastroparesis: Pathophysiology of Chronic Abdominal Pain and Current Treatment

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Chronic Abdominal Pain

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Abstract

Gastroparesis is a neuromuscular disorder of the stomach characterized by delayed gastric emptying of a standard meal in the absence of mechanical obstruction. Idiopathic, diabetic, and postsurgical gastroparesis are the most common causes of delayed gastric emptying. Approximately 20 % of patients with gastroparesis report abdominal pain as their predominant symptom, though the mechanism for this pain is not well understood. Though epigastric pain and fullness can occur, nausea and vomiting are the more common symptoms. An evaluation for non-gastric and non-gastrointestinal causes of abdominal pain, including awareness of abdominal wall syndromes, must also be considered in evaluating abdominal pain in patients with gastroparesis. The gold standard for evaluating gastroparesis is a four-hour gastric emptying study; however tests such as the water load test or electrogastrography can also aid in the evaluation of pain in patients with gastroparesis. Treatments for gastroparesis ranging from diet to drugs to gastric electrical stimulation are reviewed.

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Abbreviations

CNS:

Central nervous system

cpm:

Cycles per minute

EGG:

Electrogastrogram

FDA:

Food and Drug Administration

GERD:

Gastroesophageal reflux disease

GES:

Gastric electrical stimulation

H2 blocker:

Histamine2 receptor antagonist

IBS:

Irritable bowel syndrome

ICC:

Interstitial cells of Cajal

LUQ:

Left upper quadrant

NSAIDS:

Non-steroidal anti-inflammatory drugs

PPI:

Proton-pump inhibitor

PUD:

Peptic ulcer disease

RUQ:

Right upper quadrant

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Authors and Affiliations

  1. Section on Gastroenterology, North Carolina Baptist Medical Center, Medical Center Blvd., Winston-Salem, NC, 27157, USA

    Marcum Gillis M.D. & Kenneth L. Koch M.D.

Authors
  1. Marcum Gillis M.D.
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  2. Kenneth L. Koch M.D.
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Corresponding author

Correspondence to Kenneth L. Koch M.D. .

Editor information

Editors and Affiliations

  1. Medical Director, Carolinas Pain Institute and Clinical Research Center, Professor of Anesthesiology, Wake Forest University, School of Medicine, Winston-Salem, North Carolina, USA

    Leonardo Kapural

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Gillis, M., Koch, K.L. (2015). Gastroparesis: Pathophysiology of Chronic Abdominal Pain and Current Treatment. In: Kapural, L. (eds) Chronic Abdominal Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1992-5_7

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  • DOI: https://doi.org/10.1007/978-1-4939-1992-5_7

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  • Print ISBN: 978-1-4939-1991-8

  • Online ISBN: 978-1-4939-1992-5

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