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Gastroparesis. Pathophysiology, Clinical Presentation, Diagnosis and Treatment

  • Book

  • September 2020
  • Elsevier Science and Technology
  • ID: 4911823

Gastroparesis: Pathophysiology, Clinical Presentation, Diagnosis and Treatment is a reference book providing a centralized source of data on gastroparesis collected over the last decade. Contents include the pathophysiology, clinical presentation, diagnostic recommendations and treatment options for gastroparesis. The reference is split into broad subsections, with the strategy of first focusing on the key features of the disease and then turning to controversies, recent developments, patient support resources, the spectrum of treatment - including medical and surgical - and future directions.

Chapters will include coverage of important topics like autonomic neuropathy, the brain-gut axis, potential pathophysiological advances at the cellular level, diagnostic and therapeutic options specifically targeted at the pylorus, and the evaluation of the female predominance in gastroparesis. This is a must-have resource for scientists looking to find the next step in their research as well as healthcare professionals ranging from Gastroenterologists to Internists, Surgeons, Nutritionists, Psychiatrists, and Psychologists, Residents and Medical Students who struggle with how to optimally take care of their gastroparetic patients.

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Table of Contents

I. Introduction & clinical presentation 1. Historical perspectives on gastric motility and gastroparesis 2. Epidemiology of gastroparesis 3. Clinical presentations of gastroparesis 4. Natural history of patients with gastroparesis

II. Pathophysiology 5. Gastric dysmotility at the organ level in gastroparesis 6. Cellular pathogenesis of gastroparesis 7. Sensory dysfunction in gastroparesis 8. Pathology of gastroparesis: ICC, enteric neurons and fibrosis 9. Gastroparesis and the brain-gut axis 10. Autonomic neuropathies and gastroparesis

III. Diagnostic considerations 11. Gastric emptying scintigraphy 12. The use of wireless motility capsule in the diagnosis and monitoring of gastroparesis 13. Breath tests for the assessment of gastroparesis 14. Magnetic resonance imaging for gastric motility and function 15. Electrogastrography for suspected gastroparesis 16. Antroduodenal manometry for the evaluation of patients with suspected gastroparesis 17. Ancillary testing including barostat, SPECT, and satiety testing

IV. Clinical subsets 18. Diabetic gastroparesis 19. Postsurgical gastroparesis 20. Idiopathic gastroparesis 21. Gastroparesis from other causes 22. Pediatric gastroparesis

V. Therapeutic considerations 23. Dietary therapy for gastroparesis 24. Prokinetic agents for gastroparesis 25. Antiemetic therapy for gastroparesis 26. Abdominal pain in gastroparesis: Prevalence, potential causes and management 27. Psychiatric aspects of gastroparesis 28. Alternative, complementary medicine and cannabinoids for gastroparesis 29. Enteric tube placement for gastroparesis: Gastrostomy, gastrojejunostomy and jejunostomy 30. Gastric electrical stimulation for gastroparesis 31. Surgical management of gastroparesis

VI. Controversies & new developments 32. Studies from the NIH Gastroparesis Clinical Research Consortium: Towards improving our understanding and treatment of gastroparesis 33. Evaluating response in gastroparesis: Patient reported outcome measures and survey 34. The pyloric revolution: Patient selection 35. Endoscopic full-thickness gastric biopsy: Ready for prime time? 36. Distinguishing between functional dyspepsia and gastroparesis: Does it matter? 37. Female predominance in gastroparesis 38. A brief history and future directions of permanent, temporary, and endoscopic GES 39. Cell transplantation for gastroparesis 40. A vision of the future for gastroparesis 41. Resources for the gastroparesis patient


Richard Mccallum Professor and Founding Chair, Department of Internal Medicine, Texas Tech University Health Sciences Center, USA. Richard W. McCallum is recognized internationally as a premier thought leader in the field of neurogastroenterology and gastrointestinal motility. He is professor and founding chair of the Department of Internal Medicine at Texas Tech University Health Sciences Center and chief of its Division of Gastroenterology, Hepatology and Nutrition. He is also director of the Center for Neurogastroenterology and GI Motility.

McCallum pioneered the use of gastric electrical stimulation to treat gastroparesis, instigating a new direction of treatment for patients with nausea and vomiting. He is also a central figure in clinical research trials studying all the major prokinetics-drugs that enhance gastrointestinal motility-as well as antiemetics- agents working in the brain to block nausea. His scientific publications in peer-reviewed journals exceed 450, and he has edited more than a dozen scientific textbooks. He holds five patents.

McCallum has held several important leadership roles at the American College of Gastroenterology, the American Gastroenterological Association, the American Neurogastroenterology and Motility Society, and the Southern Society for Clinical Investigation. He has held editorial responsibilities with several major journals. He has been honored by Texas Tech University, the American Gastroenterological Association, the American Diabetes Association, the Texas Medical Association, and the Southern Society for Clinical Research. His research on the pathophysiology and treatments for gastroparesis has been funded by the National Institutes of Health (NIH), and he recently received another five-year renewal of this grant for $2 million. Henry Parkman Vice Chair of Research, Department of Medicine Professor, GI Motility Laboratory, Lewis Katz School of Medicine; and Medicine Director, ISA. Henry Parkman is the Vice Chair of Research, Department of Medicine Professor and Medicine Director at the GI Motility Laboratory at the Lewis Katz School of Medicine. His main areas of research include the use of multichannel electrogastrography to assess gastric myoelectrical activity to detect gastric motor function in patients with dyspeptic symptoms. He has developed a noninvasive test to measure simultaneously both gastric emptying and gastric volume after ingestion of a solid meal under physiologic conditions which is useful in defining the pathophysiologic factors which cause symptoms in patients with functional dyspepsia and be useful to test the effects of new pharmaceutical agents. He is also investigating gastric motility, breath tests for gastric emptying, electrogastrography (EGG), new pharmaceutical treatments for gastroparesis and functional dyspepsia, small bowel motility recordings, esophageal pH and motility recordings. John Clarke Clinical Associate Professor, Director of Esophageal Program, Stanford University, USA. John Clarke is part of the Gastroenterology & Hepatology Division at Stanford University as Director of the Esophageal Program. He previously spent 17 years in Baltimore, including 9 years on the faculty at Johns Hopkins University where he was an Associate Professor and at various times Director of Esophageal Motility, Director of Gastrointestinal Motility, Clinical Director of the Johns Hopkins Center for Neurogastroenterology, and Clinical Director of the Gastroenterology & Hepatology Division at Johns Hopkins Bayview Medical Center.

His career has combined research, education and clinical care. His clinical areas of expertise include achalasia, dysphagia, eosinophilic esophagitis, esophageal dysmotility, gastroesophageal reflux disease, gastroparesis, GI-manifestations of scleroderma and GI dysmotility. While at Johns Hopkins University, he was inducted into The Miller-Coulson Academy for Clinical Excellence, an institutional honor society for master clinicians at the time limited to 50 members across the entire university.

From an education standpoint, he has lectured in over a dozen countries, authored over 25 textbook chapters and serves on the educational affairs committee of the American College of Gastroenterology. He has also won several major teaching awards, including The Johns Hopkins University Alumni Association Award for Excellence in Teaching, given to one faculty member per year in the entire School of Medicine.

His research has focused on optimization and characterization of diagnostic studies to evaluate motility disorders, as well the relationship between therapeutic endoscopic techniques and treatment of motility disorders. He was an investigator on the NIH Gastroparesis Consortium and is also a former recipient of the AGA Don Castell Award. Braden Kuo Assistant Professor of Medicine, Massachusetts General Hospital, USA. Dr. Kuo is Assistant Professor of Medicine at Massachusettes General Hospital. His laboratory is focused on clinical and translational research in GI Motility and Visceral Pain Syndromes such as GERD, gastroparesis, constipation and irritable bowel syndrome. The research has several components including research into gut motility physiology in health and disease, understanding the brain circuitry of gut sensations, and clinical trials.