Gastroparesis pathophysiology

Gastroparesis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2]

Overview

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR

[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Pathogenesis

• The exact pathogenesis of gastroparesis is not fully understood. However, it is well known that gastric emptying process is the result of interaction of smooth muscles, extrinsic and enteric autonomic nervous system, and interstitial cells of Cajal. The final process for delay of gastric emptying is increased tone of pylorus. Gastric emptying is mediated by the vagus nerve, which involves fundus accommodation, antrum contraction, and pyloric relaxation. Interstitial cells of Cajal are the pacemaker cells in the gut with unique ability to generate and propagate slow waves in gastrointestinal muscles. This electrical slow wave activity is the determinant of the characteristic frequency of phasic contractions of the stomach, intestine and colon as well as the direction and velocity of propagation of peristaltic activity, in coordination with the enteric nervous system. Interstitial cells of Cajal regulate both gastric pacemaker activity and enteric neurons, which then initiate smooth muscle cell activity. Slow wave activity in human stomach originates from a pacemaker region at the mid/upper corpus on the greater curvature. From this pacemaker region, a band of activity is formed rapidly and propagated in an organised fashion towards the distal antrum.

OR

• It is understood that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3]
• [Pathogen name] is usually transmitted via the [transmission route] route to the human host.
• Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
• [Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
• The progression to [disease name] usually involves the [molecular pathway].
• The pathophysiology of [disease/malignancy] depends on the histological subtype.

Genetics

• [Disease name] is transmitted in [mode of genetic transmission] pattern.
• Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
• The development of [disease name] is the result of multiple genetic mutations.

Gross Pathology

• On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

• On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].