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Your search term(s) "gastroparesis" returned 55 results.

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Diabetic Gastroparesis. New England Journal of Medicine. 356(8): 820-829. February 22, 2007.

This article on diabetic gastroparesis begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies of diagnosis and therapy is then presented, followed by a review of formal guidelines. The article ends with the author's clinical recommendations. This case study features a 36-year-old man with a 20-year history of type 1 diabetes mellitus, background retinopathy, peripheral sensory neuropathy, and nephropathy who presents with a history of several months of nausea and vomiting of undigested food and bile, during which time he lost 4 kilograms. Topics covered include normal gastric emptying, the syndrome of gastroparesis-impaired gastric emptying—in patients with diabetes, diagnostic strategies, drug therapy, nutritional support, surgery, nondrug therapy, and areas of uncertainty. Key principles in the management of diabetic gastroparesis are the correction of exacerbating factors, including optimization of glucose and electrolyte levels; the provision of nutritional support; and the use of prokinetic and symptomatic therapies. 2 figures. 2 tables. 53 references.

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Gastrointestinal Electrical Stimulation for Treatment of Gastrointestinal Disorders: Gastroparesis, Obesity, Fecal Incontinence, And Constipation. Gastroenterology Clinics of North America. 36(3): 713-734. September 2007.

This article on the use of electrical stimulation to treat gastroparesis, obesity, fecal incontinence, and constipation is from a special issue of Gastroenterology Clinics of North America that focuses on gastrointestinal (GI) motility. The authors note that because these organs have their own natural pacemakers the electrical signals they generate can be altered by externally delivering electric currents by intramuscular, serosal, or intraluminal electrodes to specific sites in the GI tract. They describe various methods of GI electrical stimulation and their peripheral and central effects and mechanisms; update the status of GI electrical stimulation in the clinical settings of gastroparesis, obesity, fecal incontinence, and constipation; and predict future directions and developments of GI electrical stimulation technology and their areas of possible clinical applications. The authors conclude that, although some of the research results are still equivocal, most studies indicate that electrical stimulation is able to alter certain GI functions. 9 figures. 1 table. 123 references.

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Gastrointestinal Motility Disorders. Gastroenterology Clinics of North America. 36(3): 1-774. September 2007.

This issue of Gastroenterology Clinics of North America focuses on gastrointestinal (GI) motility disorders. The issue includes 14 articles: the classification, prevalence, and epidemiology of GI motility and functional GI disorders; neurogastroenterology and enteric sciences; evolving concepts in the cellular control of GI motility; laboratory tests used to evaluate GI motility; new technologies used for evaluation of esophageal motility disorders, including impedance, high-resolution manometry, and intraluminal ultrasound; the presentation, evaluation, and treatment of esophageal motor and sensory disorders; the presentation, evaluation, and treatment of the different manifestations of gastroesophageal reflux disease (GERD); the gastroesophageal antireflux barrier; the symptoms, evaluation, and treatment of gastroparesis; the mechanisms of symptom generation and appropriate management of patients with functional dyspepsia; the symptoms, evaluation, and treatment of irritable bowel syndrome; the evaluation and treatment of colonic and anorectal motility disorders, including constipation; the use of GI electrical stimulation for the treatment of GI disorders, including gastroparesis, obesity, fecal incontinence, and constipation; the role of bacteria in GI motility disorders; and GI motility disorders in adolescent patients, including the transition to adult health care settings. Some articles include full-color illustrations and all conclude with a list of references for further reading. A subject index concludes the issue.

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Gastrointestinal Syndromes Due to Diabetes Mellitus. IN: Veves, A.; Malik, R.A., eds. Diabetic Neuropathy: Clinical Management. 2nd ed. Totowa, NJ: Humana Press. 2007. pp 433-452.

This chapter on gastrointestinal syndromes due to diabetes mellitus is from a textbook on diabetic neuropathy. The author describes the pathophysiology, clinical findings, and management options for dealing with the main clinical syndromes associated with disturbances of gastrointestinal (GI) physiology in people with diabetes. Specific topics include esophageal dysfunction, which can be a source of bothersome upper GI symptoms, and gastroparesis, the most characteristic form of gastroduodenal dysfunction associated with diabetes. Other GI problems considered include diarrhea, irritable bowel syndrome, constipation, and fecal incontinence. The author provides advice about indications and interpretation of various diagnostic tests and reviews the more common drugs now available or expected in the future that can be used for these various clinical problems. The author notes that, from a pathophysiological perspective, alterations in gut motor, secretory, and absorptive functions may be observed in diabetes. In addition, abnormal function, that is, motility, might affect predominantly one region of the gut, manifesting itself clinically as a regional disorder. However, additional diagnostic testing may reveal the problem as involving multiple regions of the gut. 4 figures. 3 tables. 95 references.

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Gastrointestinal Syndromes Due to Diabetes Mellitus. IN: Veves, A.; Malik, R.A., eds. Diabetic Neuropathy: Clinical Management. 2nd ed. Totowa, NJ: Humana Press. 2007. pp 433-452.

This chapter on gastrointestinal (GI) symptoms due to diabetes mellitus is from a comprehensive textbook that provides general practitioners details on the latest techniques for the clinical management of diabetic neuropathy. The author cautions that disturbances may manifest as symptoms and metabolic changes that can, in turn, impinge in the management of the patient with diabetes. Diet therapy is an important component of diabetes management for all people with diabetes. The author describes the pathophysiology, clinical findings, and management options for dealing with the main clinical syndromes associated with disturbances of GI physiology in people with diabetes. These disturbances include esophageal dysfunction, gastroparesis, diarrhea, constipation, fecal incontinence, and irritable bowel syndrome (IBS). The author provides advice about indications and interpretations of various diagnostic tests used to confirm these conditions. Treatment strategies are outlined and reviewed. 4 figures. 3 tables. 95 references.

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Gastroparesis. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 6 p.

This fact sheet describes gastroparesis, also called delayed gastric emptying, a disorder in which the stomach takes too long to empty its contents. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract. Written in a question-and-answer format, the fact sheet covers the causes of gastroparesis, symptoms, the complications of the condition, diagnostic tests used to confirm gastroparesis, treatment options, and caring for patients with diabetes and gastroparesis. Treatment strategies outlined include medications such as metoclopramide, erythromycin, and domperidone; dietary changes; the use of a feeding tube; parenteral nutrition; gastric electrical stimulation; and botulinum toxin. The most common cause of gastroparesis is diabetes; the primary treatment goals for gastroparesis related to diabetes are to improve stomach emptying and regain control of blood glucose levels. Patients with diabetes and gastroparesis usually undertake changes such as six smaller meals and increased use of insulin. The fact sheet concludes with a brief section on current research efforts in this area, a summary of the important points covered in the fact sheet, a list of organizations that can provide readers with more information, and a description of the goals and activities of the National Digestive Diseases Information Clearinghouse (NDDIC). 1 figure.

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Gastroparesis: Symptoms, Evaluation, And Treatment. Gastroenterology Clinics of North America. 36(3): 619-648. September 2007.

This article on the symptoms, evaluation, and treatment of gastroparesis is from a special issue of Gastroenterology Clinics of North America that focuses on gastrointestinal (GI) motility. Gastroparesis is a disorder characterized by GI symptoms and non-GI manifestations in association with objective delays in emptying of the stomach contents. The condition may be a complication of several systemic disorders, notably diabetes mellitus, or may be of unknown cause. The diagnosis first must exclude organic diseases, which can mimic the clinical presentation of gastroparesis, and then should feature quantification of gastric emptying. Current treatments include dietary modifications, medications to stimulate gastric evacuation, enteral or parenteral nutrition, psychological counseling, and agents to reduce vomiting. Endoscopic and surgical options are increasingly used for cases refractory to treatment with medication. A final section discusses controversies and anticipated future directions for research in this area. 1 figure. 4 tables. 128 references.

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Nutritional Management of Gastroparesis in People With Diabetes Diabetes Spectrum. 20(4): 231-234.2007.

This article reviews the nutritional management of gastroparesis in people with diabetes. Gastroparesis is the slowed emptying of the stomach contents and can result in problems with fluid, electrolyte, and nutrient deficits, as well as erratic glycemic control in people with diabetes. Diagnosis must include the ruling out of mechanical or structural disorders of the gastrointestinal tract. Treatment for gastroparesis is targeted at reducing symptoms; correcting fluid, electrolyte, and nutritional deficiencies; and correcting the precipitating cause of the condition, if possible. The authors focus on nutritional interventions, discussing nutrition factors that may slow gastric emptying, including volume of food intake, fiber, fat, and medications; oral guidelines; guidelines for enteral nutrition; and ways to improve glucose control and nutritional adequacy. They conclude that treating patients with gastroparesis can be challenging. Identifying and stratifying patients into level of risk can be used to help clinicians identify those who would benefit from early support to restore nutrition and hydration status. Adjustments in the amount and timing of insulin, increased monitoring of food intake, and increased testing of blood glucose levels may be required to achieve appropriate blood glucose goals. 4 tables. 12 references.

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Nutritional Management of Gastroparesis in People With Diabetes. Diabetes Spectrum. 20(4): 231-234. Fall 2007.

This article reviews the nutritional management of gastroparesis in people with diabetes. Gastroparesis is the slowed emptying of the stomach contents and can result in fluid, electrolyte, and nutrient deficits, and erratic glycemic control, in people with diabetes. Diagnosis must include the ruling out of mechanical or structural disorders of the gastrointestinal tract. Treatment for gastroparesis is targeted at reducing symptoms, correcting fluid, electrolyte, and nutritional deficiencies, and correcting the precipitating cause of the condition, if possible. The authors focus on nutritional interventions, discussing nutrition factors that may slow gastric emptying, including volume of food intake, fiber, fat, and medications; oral guidelines; guidelines for enteral nutrition; and ways to improve glucose control and nutritional adequacy. They conclude that treating patients with gastroparesis can be very challenging. Identifying and stratifying patients into level of risk can be used to help clinicians identify those who would benefit from early support to restore nutrition and hydration status. Adjustments in the amount and timing of insulin, increased monitoring of food intake, and increased testing of blood glucose levels may all be required to achieve appropriate blood glucose goals. 4 tables. 12 references.

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Optimizing Enteral Feeding for Patients With Diabetes. Today’s Dietitian. 9(8): 50-57. August 2007.

This article helps dietitians learn to optimize enteral feeding regimens for their patients who have diabetes. Beyond basic nutritional assessments, dietitians can have a positive impact on patient care by detecting glucose problems, monitoring carefully, educating patients, and choosing appropriate enteral nutrition formulas, feeding routes, and feeding schedules. Specific topics include risks for diabetes, the classic symptoms of diabetes, hyperglycemia associated with other disorders, the importance of good glucose control to prevent complications, medications used for glucose control, goals for nutritional maintenance or repletion, the use of enteral nutrition in obese patients, patient and caregiver education regarding the timing of medications and enteral nutrition regimens, gastroparesis, electrolyte abnormalities, and the different types of enteral formulas currently on the market. The author encourages readers to stay current on the changes in the field of diabetes management. 2 figures. 1 table.

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