Disorders of gastric motility
Abstract
Gastroparesis is a disorder of delayed gastric emptying with associated symptoms of postprandial fullness, early satiety, nausea, vomiting, bloating, and abdominal pain. Functional dyspepsia is an upper gastrointestinal disorder of gut-brain interaction that presents with similar symptoms but is defined according to symptom patterns rather than gastric motor dysfunction. Although delayed gastric emptying is a defining feature of gastroparesis, other aspects of gastric neuromuscular dysfunction, such as gastric accommodation and visceral hypersensitivity might contribute to symptoms. Similarly, although functional dyspepsia is not defined by impaired gastric emptying, disordered gastric motility might underlie pathogenesis in some patients with functional dyspepsia. In the last decade, it has been increasingly recognised that these two disorders might represent varying presentations along a common continuum of neuromuscular dysfunction, although with differentiating features with respect to outcomes, diagnosis, and treatments. In this Review, an overview of gastroparesis and functional dyspepsia from the perspective of gastric motility is provided, discussing what is distinct and what is shared between these disorders.
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In the gastric fundus, impaired inhibitory neurotransmission is accompanied by reduced tonic contraction because of defective muscle contractility, whereas in the antrum both cholinergic neuromuscular transmission and smooth muscle strength are altered.
“in the gastric fundus, impaired inhibitory neurotransmission is accompanied by reduced tonic contraction because of defective muscle contractility, whereas in the antrum both cholinergic neuromuscular transmission and smooth muscle strength are altered [19, 23, 42, 43].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [43]
Advanced diabetic gastroparesis can be associated with smooth-muscle degeneration, fibrosis, collagen deposition, and ultrastructural abnormalities such as thickened basal lamina, changes that likely contribute to a hypocontractile phenotype and delayed gastric emptying.
“Moreover, advanced diabetic gastroparesis can be associated with smooth-muscle degeneration, fibrosis, collagen deposition, and ultrastructural abnormalities such as thickened basal lamina, changes that likely contribute to a hypocontractile phenotype and delayed gastric emptying [23, 42–45].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [43]
Microbiota-related changes may help explain the frequent overlap between upper and lower gastrointestinal symptoms, including the coexistence of constipation and gastroparetic complaints.
“These microbiota-related changes may also help explain the frequent overlap between upper and lower gastrointestinal symptoms, including the coexistence of constipation and gastroparetic complaints [43, 48].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [43]
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Gastroparesis after lung transplant: an underestimated factor in chronic graft dysfunction.
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- Authors
- Shin, A.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Shin, Andrea
- ORCID
- Shin, Andrea
- Venue
- The Lancet Gastroenterology & Hepatology
- Publisher
- Elsevier BV
- Published
- 2024-11
- Volume
- 9
- Issue
- 11
- Pages
- 1052-1064
- ISSN
- 2468-1156 (ISSN-L)
- 2468-1253
- OpenAlex
- W4402712986
- Cited by
- 30
- References
- 0
- Citations by year
- 2026: 17 · 2025: 12 · 2024: 1
- FWCI
- 3.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet. Gastroenterology & hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R03DK132446)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- gastroparesis, functional dyspepsia, gastric motility disorders, delayed gastric emptying, postprandial fullness, early satiety, gut-brain axis, gastric accommodation, visceral hypersensitivity, neuromuscular dysfunction
- MeSH terms
- Dyspepsia, Gastric Emptying, Gastrointestinal Motility, Humans, Gastroparesis
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