Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastroparesis is a disorder where the stomach empties contents too slowly into the small intestine with associated symptoms of nausea, vomiting, postprandial fullness, bloating, early satiety and/or abdominal pain. It is a well-established fact that the female gender is more susceptible to developing gastroparesis compared to males, although the significance and rationale behind this gender inequality remains an unresolved mystery. Several hypotheses have been proposed including an intrinsically slower stomach in females, elevated levels of sex steroid hormones, loss of neuronal nitric oxide (nNOS) expression, and possibly due to altered serotonergic signaling. Recently, our group investigated gender-associated differences in the number of interstitial cells of Cajal in the antral and pyloric smooth muscle of diabetic patients with severe refractory gastroparesis and found there was no significant difference between the 2 genders. Targeting these gender-specific mechanisms may lead towards future therapeutic options that might alleviate and/or prevent gastroparesis. Furthermore, a better-understanding of the sex-related differences in gastroparesis can allow medical practitioners to better tailor treatment options for their patients. This article will attempt to explain why females are more vulnerable to developing gastroparesis by examining the pathogenesis and molecular basis of gender-related factors that have been identified to play a role in the gender disparity of this entity.
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PMID:Gender-Related Differences in Gastroparesis. 3252 95

Gastroparesis (GP) is a chronic, gastric dysmotility disorder with significant morbidity and mortality. The hallmark of GP is the delayed emptying of the contents of the stomach in the absence of any mechanical obstruction. Patients most commonly report chronic symptoms of nausea, vomiting, feeling full quickly when eating, bloating, and abdominal pain. Treatments are limited with relatively poor efficacy. As such, children with GP are at significant risk for the development of psychological co-morbidities. In this paper, we provide a topical review of the scientific literature on the psychological, social, and emotional impacts of gastroparesis in pediatric patients. We aim to document the current state of research, identify gaps in our knowledge with appropriate recommendations for future research directions, and highlight the unique challenges pediatric patients with GP and their families may face as they manage this disease. Based on the current review, research into the psychosocial impacts in children with GP is essentially non-existent. However, when considering research in children with other chronic digestive diseases, children with GP are likely to face multiple psychosocial challenges, including increased risk for anxiety and depression, stigma, and reduced quality of life. These significant gaps in the current understanding of effects of GP across domains of childhood functioning allow for ample opportunities for future studies to address psychosocial outcomes.
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PMID:The Scarcity of Literature on the Psychological, Social, and Emotional Effects of Gastroparesis in Children. 3287 88

Mr. Editor: We present a patient underwent cryoballoon ablation for symptomatic atrial fibrillation with gastroparesis five days later. It was solved with conservative measures such as prokinetics. A 72-year-old woman with history of symptomatic paroxysmal atrial fibrillation treated with edoxaban. Pulmonary vein isolation, using a cryoballoon catheter, was performed. 5 days later she started with upper abdominal pain, bloating and vomiting. Computed tomography (CT) revealed marked gastric dilatation without any gastric or intestinal obstruction. Treatment with intravenous erythromycin was prescribed for 3 days and subsequently with oral cinitapride with good evolution. 10 days later, the disappearance of the findings with a stomach of normal dimensions without delay of gastric emptying is confirmed by esophagogastroduodenal transit. DISCUSSION Gastroparesis is an alteration characterized by a delayed gastric emptying in the absence of mechanical obstruction. It is usually manifested with postprandial fullness, belching and vomiting. The most frequent causes are: idiopathic, diabetes, Parkinson's, pharmacological and post-surgical (1). Cases of gastroparesis induced by ablation of the pulmonary veins have recently been described, which damages the periesophageal vagal plexus leading to gastric hypomotility (2,3). It is a rare but probably underdiagnosed complication because most patients remain asymptomatic. Additionally, the ablation with cryoballoon seems to increase the possibility of this collateral damage comparing to radiofrequency (2). Other risk factors associated to are: a small atrium, lower mean temperatures in the pulmonary vein and multiple applications (4). Radiology exams (radiography an CT scan) are normally enough to diagnose this entity. The diagnosis is made by radiography and CT. Although they are not able to quantify the delay of the gastric emptying they can appreciate the gastric dilatation and discard other causes. Confirmation by scintigraphy is not usually needed. In the cases described, the treatment used is prokinetic agents. Endoscopic treatment is saved for more severe patients (3). The new techniques of pulmonary ablation have increased the cases of symptomatic gastroparesis so it is important to recognize this trigger factor (2).
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PMID:GASTROPARESIS SECONDARY TO PULMONARY VEIN CRYOABLATION: A FACTOR TO CONSIDER. 3322 75


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