Abstract
Gastroparesis syndromes (GpS) are a spectrum of disorders presenting with characteristic
symptoms increasingly recognized as being gastrointestinal (GI) neuromuscular disorders
(NMDs). This review focuses on GpS as a manifestation of neurologic disorders of GI
NMD. GpS can be associated with systemic abnormalities, including inflammatory, metabolic,
and serologic disorders, as well as autoimmune antibodies via nerve and muscle targets
in the GI tract, which can be treated with immunotherapy, such as intravenous immunoglobulin.
GpS are associated with autonomic (ANS) and enteric (ENS) dysfunction. Disorders of
ANS may interact with the ENS and are the subject of continued investigation. ENS
disorders have been recognized for a century but have only recently begun to be fully
quantified. Anatomic structural changes in the GI tract are increasingly recognized
in GpS. Detailed descriptions of anatomic changes in GpS, and their correlation with
physiologic findings, have opened a new era of investigation. The management of GpS,
when viewed as GI NMD, has shifted the paradigms of both diagnosis and treatment.
This article concludes with current approaches to GpS directed at underlying neuromuscular
pathology.
Keywords
gastroparesis syndromes - neuromuscular disorders - motility - anatomic nervous system
- enteric nervous system
