Temple Researchers Seek Relief for Gastroparesis Patients

Nausea, vomiting, stomach pain, bloating – all are symptoms of gastroparesis, a complex disorder that slows or stops the movement of food from the stomach to the small intestine. The disorder often leaves patients desperate for relief. Although there are a handful of treatments to make people more comfortable, there is currently no cure.
 
"Gastroparesis is a challenging problem with few effective treatments and a lack of rigorously controlled trials," said Henry Parkman, MD, Director of the nationally-known GI Motility Lab at Temple University Hospital. The lab is one of only seven sites in the country designated by the National Institutes of Health to study gastroparesis.
 
"One possible approach to treatment is based on the hypothesis that some of the symptoms arise because of changes in certain nerves that affect sensation from the GI tract to the brain."
 
If nerves are the root of the problem, perhaps a neuromodulating drug could help relieve the symptoms of gastroparesis, thought Dr. Parkman and colleagues in the NIH Gastroparesis Consortium. Certain antidepressants – which are essentially neuromodulators – are already used to treat hard-to-control symptoms of nausea, vomiting and abdominal pain. The researchers decided to compare one of those drugs – nortriptyline – with a placebo in gastroparesis patients.
 
"Among patients with idiopathic [of unknown cause] gastroparesis, we unfortunately found no improvement in overall symptoms," said Dr. Parkman. Results of the study, which was supported by National Institute of Diabetes and Digestive and Kidney Diseases grants, were published in the December 25 issue of JAMA.
 
"Our results raise general doubts about the use of this type of antidepressant in low doses as a strategy for the treatment of idiopathic gastroparesis," he added.
 
According to Dr. Parkman, the research continues. Currently, agents are being examined that specifically affect the nausea pathways from the stomach to the brain, using the drug aprepitant. In addition, future studies will help improve the outcome of gastric electric stimulation as a means to improve gastric emptying and relieve the symptoms of gastroparesis.