Gastric dysmotility at the organ level in gastroparesis

The complex gastric motor functions are controlled by the intrinsic and extrinsic nervous systems, smooth muscle cells, interstitial cells of Cajal, excitatory and inhibitory neurotransmitters, and hormones. The stomach has specific functional regions: the fundus which serves as the reservoir, and the antrum which triturates and mixes ingested food to maximize the digestion of nutrients. Organ level abnormalities of gastric functions have been described, specifically, impairment in gastric accommodation, antral hypomotility, gastric dysrhythmias, pylorospasm, and antropyloroduodenal incoordination. Diseases such as diabetes mellitus with autonomic neuropathy and hyperglycemia, systemic sclerosis, or amyloidosis, among others impact gastric motor functions, leading to dysmotility that may affect one or more of the functions. These abnormalities present clinically with symptoms such as nausea, vomiting, postprandial fullness, early satiety, and pain. These symptoms can all impact quality of life and have presented a significant burden to the public health.