Delayed gastric emptying in patients with diffuse versus limited systemic sclerosis, unrelated to gastrointestinal symptoms and myoelectric gastric activity

BackgroundHigh feed osmolality (or osmolarity) is often suggested to be linked with adverse gastrointestinal events in preterm infants.AimTo systematically review the literature on milk feed osmolality and adverse gastrointestinal events in newborn and low birthweight infants and animals.MethodsMEDLINE, Embase, CAB Abstracts, Current Contents, BIOSIS Previews and SciSearch were searched from inception to May 2018 to identify potentially relevant studies. Inclusion criteria: randomised controlled or observational studies of newborn and low birthweight infants or animals investigating the effects of milk-based feeds with different osmolalities. Only full-text, English-language papers were included.ResultsTen human and six animal studies met the inclusion criteria. Of human studies, seven reported no differences in adverse events with varying feed osmolalities; one reported delayed gastric emptying with feed osmolarity of 539 mOsm/L compared with lower levels; one reported higher necrotising enterocolitis (NEC) incidence with feed osmolarity of 650 mOsm/L compared with 359 mOsm/L; one found higher NEC incidence with the lowest feed osmolality (326 mOsm/kg compared with 385 mOsm/kg). Of animal studies, two reported delayed gastric emptying with feed osmolarity >624 mOsm/L, one reported decreased survival due to dehydration with dietary osmolarities ≥765 mOsmol/L and none reported increased NEC incidence with differing feed osmolalities. No clear mechanisms were found, and diet composition differences limited the interpretations regarding the independent impact of osmolality.ConclusionsThere is no consistent evidence that differences in feed osmolality in the range 300–500 mOsm/kg are associated with adverse gastrointestinal symptoms in neonates.

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Frequent Occurrence of Rapid as Well as Delayed Gastric Emptying of a Corn Flakes and Milk Meal in Clinical Patients With Gastrointestinal Symptoms

Clinical Nuclear Medicine ◽

10.1097/01.rlu.0000255028.99539.d3 ◽

2007 ◽

Vol 32 (3) ◽

pp. 186-193

Author(s):

Ida Mary Santiago-Maldonado ◽

William T. Phillips

Keyword(s):

Gastric Emptying ◽

Delayed Gastric Emptying ◽

Gastrointestinal Symptoms ◽

Frequent Occurrence ◽

Corn Flakes

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Oesophageal dysmotility, delayed gastric emptying and gastrointestinal symptoms in patients with diabetes mellitus

Diabetic Medicine ◽

10.1111/j.1464-5491.2007.02236.x ◽

2007 ◽

Vol 24 (11) ◽

pp. 1235-1239 ◽

Cited By ~ 29

Author(s):

J. Faraj ◽

O. Melander ◽

G. Sundkvist ◽

R. Olsson ◽

O. Thorsson ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gastric Emptying ◽

Delayed Gastric Emptying ◽

Gastrointestinal Symptoms ◽

Patients With Diabetes ◽

Oesophageal Dysmotility

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Functional Dyspepsia and Gastroparesis

Digestive Diseases ◽

10.1159/000445226 ◽

2016 ◽

Vol 34 (5) ◽

pp. 491-499 ◽

Cited By ~ 33

Author(s):

Michael Camilleri

Keyword(s):

Gastric Emptying ◽

Functional Dyspepsia ◽

Delayed Gastric Emptying ◽

Gastrointestinal Symptoms ◽

Psychological Disorder ◽

Mechanical Obstruction ◽

Gastric Accommodation ◽

Postprandial Fullness ◽

Rumination Syndrome ◽

Upper Gastrointestinal

Background: Upper gastrointestinal disorders typically present with common symptoms. The most relevant non-mucosal diseases are gastroparesis, functional dyspepsia and rumination syndrome. The literature pertaining to these 3 conditions was reviewed. Key Messages: Gastroparesis is characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach. The cardinal symptoms include postprandial fullness (early satiety), nausea, vomiting and bloating. The most frequently encountered causes of these symptoms are mechanical obstruction (pyloric stenosis), iatrogenic disease, gastroparesis, functional dyspepsia, cyclical vomiting and rumination syndrome. The most common causes of gastroparesis are neuropathic disorders such as diabetes, idiopathic, post-vagotomy and scleroderma among myopathic disorders. Principles of management of gastroparesis include exclusion of mechanical obstruction with imaging and iatrogenic causes with careful medication and past surgical history. Prokinetics and anti-emetics are the mainstays of treatment. Functional dyspepsia is characterized by the same symptoms as gastroparesis; in addition to delayed gastric emptying, pathophysiological abnormalities include accelerated gastric emptying, impaired gastric accommodation and gastric or duodenal hypersensitivity to distension and nutrients. Novel treatments include tricyclic antidepressants in patients with normal gastric emptying, acotiamide (acetyl cholinesterase inhibitor) and 5-HT1A receptor agonists such as buspirone. Rumination syndrome is characterized by repetitive regurgitation of gastric contents occurring within minutes after a meal. Episodes often persist for 1-2 h after the meal, and the regurgitant consists of partially digested food that is recognizable in its taste. Regurgitation is typically effortless or preceded by a sensation of belching. This has been summarized as a ‘meal in, meal out, day in, day out' behavior for weeks or months, differentiating rumination from gastroparesis. Patients often have a background of psychological disorder or a prior eating disorder. Treatment is based on behavioral modification. Conclusion: Precise identification of the cause and pathophysiology of upper gastrointestinal symptoms is essential for optimal management.

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Effects of cisapride on delayed gastric emptying and upper gastrointestinal symptoms in patients with chronic liver disease: a pilot study

Current Therapeutic Research ◽

10.1016/0011-393x(95)85084-8 ◽

1995 ◽

Vol 56 (5) ◽

pp. 508-514

Author(s):

Jong Chul Rhee ◽

In Koo Kang

Keyword(s):

Liver Disease ◽

Gastric Emptying ◽

Pilot Study ◽

Chronic Liver Disease ◽

Delayed Gastric Emptying ◽

Gastrointestinal Symptoms ◽

Chronic Liver ◽

Upper Gastrointestinal Symptoms ◽

Upper Gastrointestinal

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Usefulness of a Kampo Medicine on Stress-Induced Delayed Gastric Emptying in Mice

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/3797219 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Sachiko Mogami ◽

Ryutaro Arita ◽

Miwa Nahata ◽

Naoki Fujitsuka ◽

Shin Takayama ◽

...

Keyword(s):

Gastric Emptying ◽

Delayed Gastric Emptying ◽

Psychological Symptoms ◽

Synergistic Effects ◽

Gastrointestinal Symptoms ◽

Dry Weight ◽

Kampo Medicine ◽

Gastrointestinal Dysmotility ◽

Japanese Traditional Medicine

Anxiety and depression often occur with gastrointestinal symptoms. Although the Japanese traditional medicine (Kampo medicine) bukuryoingohangekobokuto (BGH) is approved for treating anxiety, neurotic gastritis, and heartburn, its effect on gastrointestinal motility remains poorly known. This study aimed to examine the effect of BGH on delayed gastric emptying in stress model mice and clarified its action mechanism. Seven-week-old C57BL/6 male mice were acclimated for a week and fasted overnight. Stress hormone, corticotropin-releasing factor (CRF), was intracerebroventricularly injected to mice, and solid nutrient meal (ground chow and distilled water) was orally administered 1 hour after. Gastric contents were collected to evaluate gastric emptying rates by measuring its dry weight. Injection of CRF (0.3 or 1.0 μg/mouse) significantly delayed the 2-hour gastric emptying in mice. BGH (1.0 g/kg), which was administered 30 minutes before the CRF injection, significantly ameliorated the delayed gastric emptying induced by CRF (0.3 μg/mouse). BGH (0.5, 1.0 g/kg) significantly enhanced the 1-hour gastric emptying and slightly increased the 2-hour gastric emptying in mice without CRF injection. In vitro functional assays showed that components of BGH antagonized or inhibited CRF type-2, dopamine D2/D3, neuropeptide Y Y2 receptors, or acetylcholinesterase. In conclusion, the components of BGH may exert synergistic effects on improving gastric emptying via various targets. BGH is considered to be potentially useful for treating gastrointestinal dysmotility with psychological symptoms.

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