Gastroparesis is a disorder of gastric function characterized by delay in gastric emptying, frequently associated with chronic nausea and vomiting, early satiety, postprandial fullness, abdominal pain, and malnutrition that may require nutritional support. The broad objectives of this proposal is to improve our understanding of this 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 ( 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.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZDK1-GRB-8 (J2))
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Hamilton, Frank A
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Johns Hopkins University
Internal Medicine/Medicine
Schools of Medicine
United States
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Hasler, W L; May, K P; Wilson, L A et al. (2018) Relating gastric scintigraphy and symptoms to motility capsule transit and pressure findings in suspected gastroparesis. Neurogastroenterol Motil 30:
Pasricha, Pankaj J; Yates, Katherine P; Sarosiek, Irene et al. (2018) Aprepitant Has Mixed Effects on Nausea and Reduces Other Symptoms in Patients With Gastroparesis and Related Disorders. Gastroenterology 154:65-76.e11
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
Pasricha, Pankaj Jay; Snape, William (2016) Toward a Better Drug for Gastroparesis: The Problem With a Moving Target. Gastroenterology 151:20-2
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
Pasricha, Pankaj Jay (2015) Future directions in the treatment of gastroparesis. Gastroenterol Clin North Am 44:185-9

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