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Management of Abdominal Pain in Patients with Gastroparesis and Gastroparesis-Like Syndromes

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Abstract

Purpose of review

The prevalence of abdominal pain in gastroparesis ranges from 42 to 89%. Severe/very severe abdominal pain is often correlated with somatization, psychiatric conditions, and opioid use and affects the quality of life significantly. Treatment of abdominal pain in gastroparesis is complex and based on pathophysiology: phenotypes and endotypes of gastroparesis. However, the pathophysiology of gastroparesis itself is not clearly known, which makes its treatment more intriguing. In this article, we reviewed details of the pathophysiology and treatment modalities of abdominal pain in gastroparesis.

Recent findings

Advances in electrogastrogram technology such as high-resolution electrogastrogram are evolving to categorize the overlapping symptom profiles. There is emerging data about full-thickness gastric biopsy findings to understand the pathophysiologic changes in gastroparesis, but its clinical implications on management decisions are yet to be explored. Bioelectric procedures and endoscopic and surgical techniques for refractory gastroparesis have been relatively new areas of research interest. Despite reassuring results in some research studies, abdominal pain relief by those invasive therapeutic modalities needs to be further investigated through large clinical trials with both short-term and long-term follow-up of therapeutic efficacy and complications.

Summary

Management of abdominal pain-predominant gastroparesis and gastroparesis-like syndromes are challenging, similar to chronic pain management; however, due to its potential significant impact on quality of life, further research is warranted to explore the individualized treatment options based on the pathophysiology of gastroparesis and gastroparesis-like syndromes.

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Acknowledgements

The authors with like to thank Catherine McBride for assistance with manuscript preparation and submission.

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  1. University of Louisville, Louisville, KY, USA

    Garvit Chhabra MD, Le Yu Naing MD, Endashaw Omer MDMPH, Abigail Stocker MD & Thomas L. Abell MD

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Thomas Abell:

Main funding: NIH GpCRC and Gastric Dysrhythmias.

Investigator: Vanda, Neurogastrx, Processa, CinDome.

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Chhabra, G., Naing, L.Y., Omer, E. et al. Management of Abdominal Pain in Patients with Gastroparesis and Gastroparesis-Like Syndromes. Curr Treat Options Gastro 21, 411–434 (2023). https://doi.org/10.1007/s11938-023-00434-0

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