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Gastrointestinal Endoscopy Clinics of North America

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https://read.qxmd.com/read/30396533/gastroparesis-current-opinions-and-new-endoscopic-therapies
#1
EDITORIAL
Huimin Chen, Qiang Cai
No abstract text is available yet for this article.
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396532/gastroparesis-new-approaches-in-management
#2
EDITORIAL
Charles J Lightdale
No abstract text is available yet for this article.
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396531/botulinum-toxin-injection-for-treatment-of-gastroparesis
#3
REVIEW
Trisha S Pasricha, Pankaj J Pasricha
Refractory gastroparesis is among the most difficult therapeutic challenges in gastroenterology. Pyloric dysfunction has been described in a subset of patients with gastroparesis, prompting experimentation with botulinum toxin injections into the pylorus, which is relatively safe and has been successfully used in other gastrointestinal disorders. However, causality between pyloric dysfunction and symptoms of gastroparesis has never been demonstrated. Although several open-label studies showed initial promise, 2 randomized clinical trials failed to elicit a difference in clinical outcomes in botulinum toxin versus placebo...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396530/surgical-management-for-gastroparesis
#4
REVIEW
Ahmed M Zihni, Christy M Dunst, Lee L Swanström
Gastroparesis is a debilitating chronic condition of indeterminate cause. Although conservative management is the mainstay of treatment, a significant percentage of patients will need interventions. Interventions range from supportive measures, such as feeding tubes, to more radical surgeries, including endoscopic pyloromyotomy (per oral pyloromyotomy), laparoscopic pyloroplasty, laparoscopic gastric stimulator placement, and even subtotal or total gastrectomy. The authors present some current treatment algorithms focused on the treatment side of the spectrum along with outcomes data to support the various approaches...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396529/gastric-electrical-stimulator-for-treatment-of-gastroparesis
#5
REVIEW
Hadi Atassi, Thomas L Abell
Patients with gastroparesis sometimes suffer from intractable nausea and vomiting, abdominal pain, and bloating, as well as a host of other symptoms that can often be difficult to control. Initially, patients are treated conservatively; some do well with conservative management but unfortunately some do not. Over the years, studies have shown the benefits of gastric electrical stimulation, which often results in symptomatic improvement and improvement in gastric emptying times. This article discusses the history of gastric electrical stimulation and its use in clinical practice to help those suffering from gastroparesis that is refractory to conservative medical management...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396528/symptomatic-management-of-gastroparesis
#6
REVIEW
Christopher M Navas, Nihal K Patel, Brian E Lacy
Gastroparesis is a chronic and debilitating neuromuscular disorder of the upper gastrointestinal tract. Symptoms of gastroparesis include nausea, vomiting, epigastric pain, early satiety, and weight loss. Treating gastroparesis can be difficult. Dietary changes may improve symptoms in patients with mild disease. A variety of medications can be used to treat symptoms of nausea and vomiting, although most have not been subjected to randomized controlled trials and only one is approved by the Food and Drug Administration (metoclopramide)...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396527/evaluation-of-patients-with-suspected-gastroparesis
#7
REVIEW
Lawrence A Szarka, Michael Camilleri
There is substantial overlap between the symptoms of gastroparesis and a variety of alternative disorders. These conditions include rumination syndrome, drug-induced gastric emptying delay, cannabinoid hyperemesis syndrome, and eating disorders, which can be identified based on the history alone. The remaining patients require a diagnostic approach of physical examination, laboratory tests, evaluation with esophagogastroduodenoscopy or contrast radiography, and a test to measure gastric emptying. Symptomatic patients who have normal nutritional status and gastric emptying that is either normal or mildly delayed should be diagnosed with functional dyspepsia, whereas patients with moderate or severe gastric emptying delay are diagnosed with gastroparesis...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396526/clinical-manifestation-and-natural-history-of-gastroparesis
#8
REVIEW
Priyadarshini Loganathan, Mahesh Gajendran, Richard W McCallum
Although gastroparesis was described more than 60 years ago, the natural history and the long-term outcome are still being clarified. The patients with more severe gastroparesis often seek health care treatment in university medical centers specializing in gastrointestinal motility disorders and hence reports in the literature tend to be based on this population and may not be representative of the entire spectrum. The clinical manifestations of gastroparesis are heterogeneous but a significant proportion of patients end up with substantially poorer quality of life...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396525/outcomes-of-per-oral-endoscopic-pyloromyotomy-in-the-united-states
#9
REVIEW
Parit Mekaroonkamol, Sunil Dacha, Vaishali Patel, Baiwen Li, Hui Luo, Shanshan Shen, Huimin Chen, Qiang Cai
Per oral endoscopic pyloromyotomy (POP) has emerged as an endoscopic intervention for refractory gastroparesis. Early experience in the United States showed exciting clinical response rate, reduced gastroparesis symptoms, improved quality of life, and decreased gastric-emptying time during midterm follow-up up to 18 months. One recent study also showed that the number of patient emergency room visits and hospitalizations decreased significantly after POP. The procedure is technically feasible and safe. As more data become available, it is important to identify patients who would benefit most from this novel procedure...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396524/diabetic-gastroparesis-and-nondiabetic-gastroparesis
#10
REVIEW
Shanshan Shen, Jennifer Xu, Vladimir Lamm, Cicily T Vachaparambil, Huimin Chen, Qiang Cai
Gastroparesis can be divided into diabetic and nondiabetic, and the 3 main causes of gastroparesis are diabetic, postsurgical, and idiopathic. Delayed gastric emptying is the main manifestation of motility disorders for gastroparesis. Symptoms of gastroparesis are nonspecific and severity can vary. Nausea and vomiting are more common in diabetic gastroparesis whereas abdominal pain and early satiety are more frequent in idiopathic gastroparesis. Medication is still the mainstay of treatment of gastroparesis; however, the development of gastric electric stimulation and gastric peroral endoscopic pyloromyotomy brings more options for the treatment of diabetic and nondiabetic gastroparesis...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396523/outcomes-and-future-directions-of-per-oral-endoscopic-pyloromyotomy-a-view-from-france
#11
REVIEW
Jérémie Jacques, Romain Legros, Jacques Monteil, Denis Sautereau, Guillaume Gourcerol
Gastroparesis is a challenging functional gastroenterological disorder, the complex pathophysiology of which hampers development of therapeutic modalities. Per-oral pyloromyotomy (POP) is a promising endoscopic therapy with a short-term clinical success rate of greater than 80%. Interest in POP is increasing, particularly in France, a country in which there is considerable expertise in submucosal endoscopy and functional disorders. Long-term follow-up and pyloric function evaluation are needed to assess the efficacy of POP in gastroparetic patients...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396522/gastric-emptying-scintigraphy-before-gastric-per-oral-endoscopic-myotomy-imaging-may-inform-treatment
#12
REVIEW
Robert M Spandorfer, Yin Zhu, Parit Mekaroonkamol, James Galt, Raghuveer Halkar, Qiang Cai
Gastric emptying scintigraphy (GES) helps to diagnose gastroparesis and is typically only used for whole stomach retention patterns. However, it may provide significantly more information when looking specifically at proximal and distal retention patterns. This article reviews global GES changes following gastric per oral endoscopic myotomy; how global, proximal, and distal GES measurements correlate to gastroparesis symptoms; and how proximal and distal GES may serve as proxies for the various mechanisms involved in gastroparesis...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396521/technical-aspects-of-peroral-endoscopic-pyloromyotomy
#13
REVIEW
Jie Tao, Vaishali Patel, Parit Mekaroonkamol, Hui Luo, Baiwen Li, Qunye Guan, Shanshan Shen, Huimin Chen, Qiang Cai
Gastric peroral endoscopic pyloromyotomy (G-POEM or POP) is a feasible and effective procedure for the treatment of refractory gastroparesis. G-POEM is a technically demanding endoscopic procedure. As of yet, there is no consensus on the technique. A variety of techniques have been reported in published studies. The essential technical steps of the procedure are (1) establishment of submucosal tunnel in gastric antrum, (2) identification of the pyloric muscular ring, (3) selective circular myotomy, and (4) a 2...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396520/stent-placement-for-the-treatment-of-gastroparesis
#14
REVIEW
Olaya I Brewer Gutierrez, Mouen A Khashab
Gastroparesis is a syndrome of delayed gastric emptying. First-line treatment includes prokinetic medications. Those refractory to medical treatment are occasionally considered for endoscopic or surgical treatment options, with unpredictable response. The pylorus plays a key role in gastric emptying, with pylorospasm as the underlying mechanism of gastroparesis in some patients. Procedures aiming at disruption of the pylorus have improved gastroparesis symptoms in this subset of patients. These include transpyloric stenting, used for inpatients with refractory symptoms to allow hospital discharge or as a triage to assess symptoms response in patients considered for more definite therapies such as pyloromyotomy...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30396519/epidemiology-and-pathophysiology-of-gastroparesis
#15
REVIEW
Baha Moshiree, Michael Potter, Nicholas J Talley
Gastroparesis is a complex syndrome with symptoms that include nausea, vomiting, and postprandial abdominal pain, and is frequently accompanied by significant delays in gastric emptying. The pathophysiology of diabetic gastroparesis is fairly well understood; however, idiopathic gastroparesis, which accounts for one-third of all cases, may stem from infections, or autoimmune or neurologic disorders, among other causes. To date, few population-based studies have estimated the true prevalence and incidence of gastroparesis...
January 2019: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30241649/preface
#16
EDITORIAL
John M Poneros
No abstract text is available yet for this article.
October 2018: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30241648/management-of-benign-pancreatic-diseases
#17
EDITORIAL
Charles J Lightdale
No abstract text is available yet for this article.
October 2018: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30241647/total-pancreatectomy-with-autologous-islet-cell-transplantation
#18
REVIEW
Beth Schrope
First described in the early 1980s, total pancreatectomy with autologous islet cell transplantation for the treatment of chronic pancreatitis is still only offered in select centers worldwide. Indications, process details including surgery as well as islet isolation, and results are reviewed. In addition, areas for further research to optimize results are identified.
October 2018: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30241646/the-role-of-genetics-in-pancreatitis
#19
REVIEW
Aws Hasan, Dagmara I Moscoso, Fay Kastrinos
Individuals with acute recurrent and chronic pancreatitis may have an inherited predisposition to the development of the disease. Pancreatitis in the setting of a significant family history of the disease can be classified as hereditary or familial pancreatitis. In this article, the authors closely examine the specific genes implicated in pancreatitis, investigate the role of genetic testing for diagnosis, and describe the impact of genetic testing results on clinical management.
October 2018: Gastrointestinal Endoscopy Clinics of North America
https://read.qxmd.com/read/30241645/celiac-plexus-block-and-neurolysis-a-review
#20
REVIEW
Amit H Sachdev, Frank G Gress
Pain is often associated with chronic pancreatitis and pancreatic cancer. Often times opioids are used to treat pain; however, the use of opioids is frequently difficult. Endoscopic ultrasound-guided celiac plexus block and celiac plexus nuerolysis are safe and effective modalities used to alleviate pain. Celiac plexus block is a transient interruption of the plexus by local anesthetic, while celiac plexus neurolysis is prolonged interruption of the transmission of pain from the celiac plexus using chemical ablation...
October 2018: Gastrointestinal Endoscopy Clinics of North America
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