Motility and Functional Disorders of the Stomach: Diagnosis and Management of Functional Dyspepsia and Gastroparesis

摘要

Functional dyspepsia and gastroparesis are the most common functional and motility disorders of the stomach. Functional dyspepsia is a heterogeneous syndrome with multiple pathophysiologies that refers to symptoms originating in the gastroduodenal region in the absence of an organic cause. Patients with functional dyspepsia may present with primarily postprandial symptoms including fullness, early satiety, and bloating, while other patients may present with the predominant symptom of epigastric pain. Gastroparesis is a symptomatic chronic disorder characterized by delayed gastric emptying without mechanical obstruction. Although gastroparesis is often caused by diabetes and prior gastric surgery, the underlying cause may not be found in many patients. Clinical manifestation of gastroparesis is variable. Patients present with debilitating nausea and vomiting resulting in weight loss and dehydration. Other patients may present with postprandial symptoms of postprandial fullness, early satiety, and effortless regurgitation. In this review, an update on the underlying mechanisms, clinical features, diagnostic evaluation, and treatment for functional dyspepsia and gastroparesis is provided.