Gastroparesis is a disorder of gastric function characterized by delay in gastric emptying, frequentiy associated with chronic nausea and vomiting, eariy satiety, postprandial fullness, abdominal pain, and malnutrition that may require nutritional support. The broad objectives of this proposal is to improve our understanding ofthls disorder and advancing the diagnosis and treatment of gastroparesis and related disorders. We propose to do this through three specific aims, as follows:
Specific Aim 1 : To complete ongoing and approved studies initiated by the NIH-funded GpCRC (the Gastroparesis Clinical Research Consortium, a collaboration between six clinical sites and data coordinating center). These include (1) a randomized trial of nortriptyline vs. placebo for idiopathic gastroparesis, (2) a pilot study of safety, feasibility and potential efficacy of continuous glucose monitoring and insulin pump therapy in diabetic gastroparesis, (3) a randomized trial of aprepitant vs. placebo for the relief of nausea in patients with chronic nausea and vomiting of presumed gastric origin and (4) a tissue study from full thickness gastric biopsies.
Specific Aim 2 : To maintain, expand, and refine the Gastroparesis Registry (ClinicalTrials.gov NCT00398801) in order to enable critical additional analyses of the clinical data and biosamples. The first Registry patient with gastroparesis was recruited in February 2007 and a total of 587 patients were enrolled by end of recruitment in March 2010.
Our aim i s to have at least four years of follow-up on all patients and with up to 9 years for some patients. This will require maintenance of the Registry and continued periodic follow-up visits over the next five years.
Specific Aim 3 : To understand nitrergic control of gastric sensorimotor function: correlation with gender, diabetes and gastric emptying phenotype in patients with gastroparesis and chronic unexplained nausea and vomiting.

Public Health Relevance

Gastroparesis has a devastating impact on quality of life and predominantly affects younger women. This research will help find new ways to diagnose and treat this condition as well as related disorders characterized by nausea and vomiting.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
2U01DK073983-06
Application #
8115535
Study Section
Special Emphasis Panel (ZDK1-GRB-8 (J2))
Program Officer
Hamilton, Frank A
Project Start
2006-04-15
Project End
2012-08-31
Budget Start
2011-09-01
Budget End
2012-08-31
Support Year
6
Fiscal Year
2011
Total Cost
$433,723
Indirect Cost
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Parkman, H P; Hallinan, E K; Hasler, W L et al. (2017) Early satiety and postprandial fullness in gastroparesis correlate with gastroparesis severity, gastric emptying, and water load testing. Neurogastroenterol Motil 29:
Grover, M; Bernard, C E; Pasricha, P J et al. (2017) Diabetic and idiopathic gastroparesis is associated with loss of CD206-positive macrophages in the gastric antrum. Neurogastroenterol Motil 29:
Koch, K L; Hasler, W L; Yates, K P et al. (2016) Baseline features and differences in 48 week clinical outcomes in patients with gastroparesis and type 1 vs type 2 diabetes. Neurogastroenterol Motil 28:1001-15
Harer, Kimberly N; Pasricha, Pankaj J (2016) Chronic Unexplained Nausea and Vomiting or Gastric Neuromuscular Dysfunction (GND)? An Update on Nomenclature, Pathophysiology and Treatment, and Relationship to Gastroparesis. Curr Treat Options Gastroenterol 14:410-419
Parkman, H P; Hallinan, E K; Hasler, W L et al. (2016) Nausea and vomiting in gastroparesis: similarities and differences in idiopathic and diabetic gastroparesis. Neurogastroenterol Motil 28:1902-1914
Pasricha, Pankaj Jay (2015) Hunger games: is your stomach making you fat? Gastroenterology 148:491-3
Angeli, Timothy R; Cheng, Leo K; Du, Peng et al. (2015) Loss of Interstitial Cells of Cajal and Patterns of Gastric Dysrhythmia in Patients With Chronic Unexplained Nausea and Vomiting. Gastroenterology 149:56-66.e5
Pasricha, Pankaj J; Yates, Katherine P; Nguyen, Linda et al. (2015) Outcomes and Factors Associated With Reduced Symptoms in Patients With Gastroparesis. Gastroenterology 149:1762-1774.e4
John, George K; Singh, Vikesh K; Pasricha, Pankaj J et al. (2015) Delayed Gastric Emptying (DGE) Following Total Pancreatectomy with Islet Auto Transplantation in Patients with Chronic Pancreatitis. J Gastrointest Surg 19:1256-61
Hasler, William L (2015) Symptomatic management for gastroparesis: antiemetics, analgesics, and symptom modulators. Gastroenterol Clin North Am 44:113-26

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