The Serotonin Signaling System: From Basic Understanding To Drug Development for Functional GI Disorders

https://www.gastrojournal.org/article/S0016-5085(04)01634-8/pdf

American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis

This literature review and the recommendations herein were prepared for the American Gastroenterological Association Clinical Practice Committee. The paper was approved by the Committee on May 16, 2004, and by the AGA Governing Board on September 23, 2004.

Technical review on the diagnosis and treatment of gastroparesis

AGA technical review on management of oropharyngeal dysphagia

This clinical review on the treatment of patients with gastroparesis is a consensus document developed by the American Motility Society Task Force on Gastroparesis. It is a multidisciplinary effort with input from gastroenterologists and other specialists who are involved in the care of patients with gastroparesis. To provide practical guidelines for treatment, this document covers results of published research studies in the literature and areas developed by consensus agreement where clinical research trials remain lacking in the field of gastroparesis.

/pdf/treatment-of-gastroparesis-a-multidisciplinary-clinical-1dx8oxjni2.pdf

Treatment of gastroparesis: a multidisciplinary clinical review

Previous studies showed that symptoms of oesophageal motor disorders can be misinterpreted as indicating anorexia nervosa and that in primary anorexia nervosa gastric motility is frequently impaired. We investigated in 32 women with bulimia nervosa whether symptoms of oesophageal motor disorders could be obscured by or be mistaken as forming part of bulimic behaviour, and whether impaired gastric motility was frequent as well. Oesophageal motility was normal in 18 of 26 patients studied, another four had incomplete lower oesophageal sphincter relaxation. Two patients had vigorous achalasia and each one achalasia and diffuse oesophageal spasm, all of whom experienced two types of vomiting: one self-induced and one involuntary, in which the vomit was non-acidic and tasted as the preceding meal. Gastric emptying of a semisolid meal was studied in all patients except of the eight with oesophageal motor abnormalities. Emptying was significantly slower than in healthy controls and grossly delayed in nine of 24 patients. Antral contraction amplitudes were lower and increased less postcibally than in controls. In conclusion (i) bulimic behaviour can obscure symptoms of oesophageal motor disorders and (ii) gastric emptying is frequently delayed in bulimia nervosa.

https://gut.bmj.com/content/gutjnl/31/3/259.full.pdf

Oesophageal and gastric motor activity in patients with bulimia nervosa.

It has been hypothesized that, in the absence of acute or chronic pain, a tonically active system exists involving opioid peptides, which ensures a certain level of pain insensitivity Although various studies have failed to support this concept, it has been reported that in conditions of both experimentally induced and clinical pain, high doses of the opioid antagonist naloxone induced a state of hyperalgesia and thus seemed to set off this hypothetical system Lower doses were, however, without effect or even acted as analgesics This study investigated the effect of 5 and 20 mg naloxone iv, compared to placebo, on the perception of pain in healthy humans Pain was induced by two methods, using electrical and thermal stimulation of the skin, which have previously been shown to be sensitive to the effects of opioid as well as of non-steroidal anti-inflammatory analgesics Each of 12 males and 12 females participated in 3 experimental sessions, in which the treatments were administered double-blind according to a Latin square design Threshold and tolerance to electrically induced pain and threshold to thermally induced pain were measured at 30 min intervals for 90 min before and 90 min after drug administration Electrical stimuli were square wave constant current impulses of linearly increasing intensity; thermal stimuli were of constant intensity and variable duration Threshold and tolerance to electrically induced pain were not altered by either dose of naloxone, whereas the threshold to thermally induced pain was significantly higher after both 5 and 20 mg naloxone than after placebo, the effects of the two naloxone doses not differing from each other Subjects who were relatively pain sensitive did not react differently to the pain stimuli after naloxone administration than did subjects who were relatively pain insensitive These results, which are consistent with those of previous studies, cast further doubt on the validity of the concept that there is, in the absence of pain, a tonically active system involving endogenous opioids, which ensures a level of pain insensitivity

Naloxone does not alter the perception of pain induced by electrical and thermal stimulation of the skin in healthy humans.

https://www.gastrojournal.org/article/0016-5085(91)90386-Y/pdf

High incidence of esophageal motor disorders in consecutive patients with globus sensation

Upper gastrointestinal endoscopy findings in patients with long-standing bulimia nervosa

1. The selective 5-HT3 receptor antagonist, ICS 205-930 (Sandoz), has been reported to have potent effects on gastric smooth muscle in vivo and to enhance gastric emptying in animals and in man. 2. This study investigated the effects of ICS 205-930 on fat-delayed gastric emptying of a semisolid meal and antral motor activity in humans. 3. Twelve healthy men participated in each of three studies in which 10 or 20 mg of ICS 205-930 or placebo were infused i.v. in a random double-blind fashion. Gastric emptying and antral motor activity were studied scintigraphically. 4. Gastric emptying was not altered after 10 mg but slower after 20 mg of ICS 205-930 than after placebo. Emptying after 20 mg of ICS 205-930 was significantly slower than after 10 mg of ICS 205-930. 5. Antral contraction amplitude was slightly lower after 20 mg of ICS 205-930 than after placebo, whereas the effects of 10 mg ICS 205-930 did not differ from those of placebo. 6. The results suggest that the investigated doses of ICS 205-930 have only slight effects on gastric motor activity of healthy young men, with 20 mg reducing the rate of emptying.

Thalia-Anthi Abatzi

Papers

Oesophageal and gastric motor activity in patients with bulimia nervosa.

Naloxone does not alter the perception of pain induced by electrical and thermal stimulation of the skin in healthy humans.

High incidence of esophageal motor disorders in consecutive patients with globus sensation

Upper gastrointestinal endoscopy findings in patients with long-standing bulimia nervosa

Effects of the 5-HT3 receptor antagonist ICS 205-930 on fat-delayed gastric emptying and antral motor activity.