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Pyloric distensibility in health and disease

Publisher

AMER PHYSIOLOGICAL SOC
DOI: 10.1152/ajpgi.00460.2020

Keywords

compliance; gastric emptying; gastroparesis; pyloromyotomy; pylorus

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Recent research indicates that pyloric distensibility may serve as an important indicator for evaluating patients with gastroparesis, as its decrease is strongly correlated with gastric emptying and symptoms. Furthermore, pyloric distensibility may also predict the efficacy of endoscopic techniques targeting the pylorus.
Until recently, gastric motility measurements in humans were mostly limited to accommodation (using barostat or 3-dimensional imaging studies of gastric volume) and gastric emptying tests, the latter being the only one performed in routine clinical care. Accurate and easy to use techniques were lacking to assess pyloric function in health and disease. Recently, pyloric distensibility has been developed and validated to assess pyloric opening. Several studies confirmed that pyloric distensibility was decreased in gastroparesis and correlated with gastric emptying as well as gastroparesis symptoms. In addition, pyloric distensibility may predict outcome of endoscopic techniques targeting the pylorus, namely intrapyloric botulinum toxin injection and gastric per-oral pyloromyotomy. Pyloric distensibility appears therefore to be a promising and useful new tool in the workup of gastroparesis patients.

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