Abstract:
BACKGROUND: Gastric accommodation is an essential gastric motor function which occurs following ingestion of a meal. Impaired gastric fundic accommodation (IFA) is associated with dyspeptic symptoms. Gastric accommodation is mediated by the vagal pathway with several important physiologic factors such as duodenal nutrient feedback playing a significant role. IFA has been described as a pathophysiologic factor in several gastrointestinal disorders including functional dyspepsia, diabetic gastropathy, post-Nissen fundoplication, postsurgical gastrectomy, and rumination syndrome. Modalities for gastric accommodation assessment include gastric barostat, intragastric meal distribution via scintigraphy, drinking tests (eg, water load), SPECT, MRI, 2D and 3D ultrasound, and intragastric high-resolution manometry. Several treatment options including sumatriptan, buspirone, tandospirone, ondansetron, and acotiamide may improve symptoms by increasing post-meal gastric volume.
OBJECTIVE: Our aim is to provide an overview of the physiology, diagnostic modalities, and therapies for IFA. A literature search was conducted on PubMed, Google Scholar, and other sources to identify relevant studies available until December 2020. Gastric accommodation is an important gastric motor function which if impaired, is associated with several upper gastrointestinal disorders. There are an increasing number of gastric accommodation testing modalities; however, each has facets which warrant consideration. Evidence regarding potentially effective therapies for IFA is growing.
摘要:
背景:胃调节是一种重要的胃运动功能,在进食后发生。胃底调节功能受损(IFA)与消化不良症状有关。胃调节是由迷走神经途径介导的,十二指肠营养反馈等几个重要的生理因素起着重要作用。IFA已被描述为几种胃肠道疾病的病理生理因素,包括功能性消化不良。糖尿病性胃病,尼森胃底折叠术后,术后胃切除术,和反思性综合症。胃调节评估的模式包括胃气压调节器,通过闪烁扫描的胃内膳食分布,饮酒测试(例如,水负荷),SPECT,MRI,二维和三维超声,和胃内高分辨率测压。几种治疗选择,包括舒马曲坦,Buspirone,坦度螺酮,昂丹司琼,和acotiamide可以通过增加餐后胃体积来改善症状。
目的:我们的目的是提供生理学概述,诊断方式,和IFA的治疗方法。在PubMed上进行了文献检索,谷歌学者,和其他来源,以确定2020年12月之前可用的相关研究。胃调节是一种重要的胃运动功能,如果受损,与几种上消化道疾病有关。有越来越多的胃适应测试模式;然而,每个人都有值得考虑的方面。关于IFA潜在有效疗法的证据正在增加。