Diabetic gastropathy (gastric neuromuscular dysfunction in diabetes mellitus a review of symptoms, pathophysiology, and treatment)

KL Koch - Digestive diseases and sciences, 1999 - Springer
KL Koch
Digestive diseases and sciences, 1999Springer
Diabetic gastropathy is a term that encompassesa number of neuromuscular dysfunctions of
the stomach, including abnormalities of gastric contractility, tone, and myoelectrical activity in
patients with diabetes. These abnormalities range fromtachygastrias to antral hypomotility
and frankgastroparesis. Diabetic gastropathies may be acutelyproduced during
hyperglycemia. Symptoms of chronicdiabetic gastropathy include chronic nausea, vague
epigastricdiscomfort, postprandial fullness, early satiety, andvomiting. Because these …
Abstract
Diabetic gastropathy is a term that encompassesa number of neuromuscular dysfunctions of the stomach,including abnormalities of gastric contractility, tone,and myoelectrical activity in patients with diabetes. These abnormalities range fromtachygastrias to antral hypomotility and frankgastroparesis. Diabetic gastropathies may be acutelyproduced during hyperglycemia. Symptoms of chronicdiabetic gastropathy include chronic nausea, vague epigastricdiscomfort, postprandial fullness, early satiety, andvomiting. Because these symptoms are nonspecific, otherdisorders such as mechanical obstruction of thegastrointestinal tract, gastroesophageal reflux disease,cholecystitis, pancreatitis, mesenteric ischemia, anddrug effects should be considered. Neuromuscularabnormalities of the stomach may be assessednoninvasively with gastric emptying tests,electrogastrography, and ultrasound. Gastrokineticagents such as metoclopramide, cisapride, domperidone,and erythromycin increase fundic or antral contractionsand/or eradicate gastric dysrhythmias. Diet and glucose controlalso are important in the management of diabeticgastropathy. As the pathophysiology of diabeticgastropathy is better understood, more specific andimproved treatments will evolve.
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