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10.3390/life13081743
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Review

Imaging in Gastroparesis: Exploring Innovative Diagnostic Approaches, Symptoms, and Treatment

by
Francesco Vito Mandarino
1,*,†,
Sabrina Gloria Giulia Testoni
1,†,
Alberto Barchi
1,
Francesco Azzolini
1,
Emanuele Sinagra
2,
Gino Pepe
3,
Arturo Chiti
3 and
Silvio Danese
1
1
Department of Gastroenterology and Gastrointestinal Endoscopy, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
2
Gastroenterology & Endoscopy Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
3
Department of Nuclear Medicine, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Life 2023, 13(8), 1743; https://doi.org/10.3390/life13081743
Submission received: 14 July 2023 / Revised: 8 August 2023 / Accepted: 12 August 2023 / Published: 14 August 2023
(This article belongs to the Special Issue Imaging of Gastrointestinal Diseases: Issues and Challenges)
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Abstract

Gastroparesis (GP) is a chronic disease characterized by upper gastrointestinal symptoms, primarily nausea and vomiting, and delayed gastric emptying (GE), in the absence of mechanical GI obstruction. The underlying pathophysiology of GP remains unclear, but factors contributing to the condition include vagal nerve dysfunction, impaired gastric fundic accommodation, antral hypomotility, gastric dysrhythmias, and pyloric dysfunction. Currently, gastric emptying scintigraphy (GES) is considered the gold standard for GP diagnosis. However, the overall delay in GE weakly correlates with GP symptoms and their severity. Recent research efforts have focused on developing treatments that address the presumed underlying pathophysiological mechanisms of GP, such as pyloric hypertonicity, with Gastric Peroral Endoscopic Myotomy (G-POEM) one of these procedures. New promising diagnostic tools for gastroparesis include wireless motility capsule (WMC), the 13 carbon-GE breath test, high-resolution electrogastrography, and the Endoluminal Functional Lumen Imaging Probe (EndoFLIP). Some of these tools assess alterations beyond GE, such as muscular electrical activity and pyloric tone. These modalities have the potential to characterize the pathophysiology of gastroparesis, identifying patients who may benefit from targeted therapies. The aim of this review is to provide an overview of the current knowledge on diagnostic pathways in GP, with a focus on the association between diagnosis, symptoms, and treatment.
Keywords: gastroparesis; gastric emptying study; scintigraphy; functional dyspepsia gastroparesis; gastric emptying study; scintigraphy; functional dyspepsia

Share and Cite

MDPI and ACS Style

Mandarino, F.V.; Testoni, S.G.G.; Barchi, A.; Azzolini, F.; Sinagra, E.; Pepe, G.; Chiti, A.; Danese, S. Imaging in Gastroparesis: Exploring Innovative Diagnostic Approaches, Symptoms, and Treatment. Life 2023, 13, 1743. https://doi.org/10.3390/life13081743

AMA Style

Mandarino FV, Testoni SGG, Barchi A, Azzolini F, Sinagra E, Pepe G, Chiti A, Danese S. Imaging in Gastroparesis: Exploring Innovative Diagnostic Approaches, Symptoms, and Treatment. Life. 2023; 13(8):1743. https://doi.org/10.3390/life13081743

Chicago/Turabian Style

Mandarino, Francesco Vito, Sabrina Gloria Giulia Testoni, Alberto Barchi, Francesco Azzolini, Emanuele Sinagra, Gino Pepe, Arturo Chiti, and Silvio Danese. 2023. "Imaging in Gastroparesis: Exploring Innovative Diagnostic Approaches, Symptoms, and Treatment" Life 13, no. 8: 1743. https://doi.org/10.3390/life13081743

APA Style

Mandarino, F. V., Testoni, S. G. G., Barchi, A., Azzolini, F., Sinagra, E., Pepe, G., Chiti, A., & Danese, S. (2023). Imaging in Gastroparesis: Exploring Innovative Diagnostic Approaches, Symptoms, and Treatment. Life, 13(8), 1743. https://doi.org/10.3390/life13081743

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