Arthi Sanjeevi1. 1. Medical College of Virginia, Virginia Commonwealth University Medical Center, Richmond, Virginia 23298, USA. asanjeevi@vcu.edu
Abstract
PURPOSE OF REVIEW: This review focuses on progress made in the field of gastric motility in the past year, emphasizing advances in understanding the motor physiology of the stomach in health and disease; noninvasive imaging technology and data on novel pharmacotherapeutics and other therapeutic interventions for gastroparesis. RECENT FINDINGS: The differential conduction pattern in the interstitial cell of Cajal is responsible for the generation of the full spatio-temporal pattern of gastric peristalsis. The mitochondrial powerhouse provides the driving potential for the gastric slow waves. Females are more dependent on the nitrenergic system for gastric relaxation, which is predominantly affected in diabetes. The noninvasive modalities to evaluate gastric function have undergone substantial evolution in the past year. On the therapeutic front, a new generation of medications has been tested and holds promise for the near future. Gastric electrical stimulation is a viable option for medically refractory gastroparesis. SUMMARY: Using dynamic imaging modalities, the pathophysiology of dyspepsia is becoming better understood and recognized as an end point of multifactorial dysfunction of the enteric neural circuitry. Mechanism-targeted drugs, stem cell transplantation and electrical stimulation options are becoming available.
PURPOSE OF REVIEW: This review focuses on progress made in the field of gastric motility in the past year, emphasizing advances in understanding the motor physiology of the stomach in health and disease; noninvasive imaging technology and data on novel pharmacotherapeutics and other therapeutic interventions for gastroparesis. RECENT FINDINGS: The differential conduction pattern in the interstitial cell of Cajal is responsible for the generation of the full spatio-temporal pattern of gastric peristalsis. The mitochondrial powerhouse provides the driving potential for the gastric slow waves. Females are more dependent on the nitrenergic system for gastric relaxation, which is predominantly affected in diabetes. The noninvasive modalities to evaluate gastric function have undergone substantial evolution in the past year. On the therapeutic front, a new generation of medications has been tested and holds promise for the near future. Gastric electrical stimulation is a viable option for medically refractory gastroparesis. SUMMARY: Using dynamic imaging modalities, the pathophysiology of dyspepsia is becoming better understood and recognized as an end point of multifactorial dysfunction of the enteric neural circuitry. Mechanism-targeted drugs, stem cell transplantation and electrical stimulation options are becoming available.