New England Gastropareis Consortium: Neurobiology of Gastroparesis

ABSTRACT Symptoms of gastroparesis include chronic nausea and vomiting, early satiation, postprandial fullness, abdominal distention and frequently pain. While initially conceptualized as a disorder of enteric motor dysfunction (i.e., delayed gastric emptying), growing research suggests both (1) a disconnect between symptom severity and emptying severity, and (2) largely ineffectiveness of treatments that target motor dysfunction. Although the causes of gastroparesis can be multi-factorial, when the disease becomes chronic and the severity of the symptoms result in a high impact on Quality of Life (QOL), complex pathologies may begin to evolve in the enteric and central nervous system beyond just motor abnormalities contributing to other sensory defects. Further profiling of biopsychosocial constructs in gastroparesis is needed, as such constructs could be targeted by novel interventions. To accomplish these goals, we propose to continue with the New England Gastroparesis Collaborative as part of the NIH Gastroparesis Consortium. The multi-center network will help recruit to our proposal of further gastroparesis patient characterization in the Registries and continuation of various multi-center studies for gastroparesis. In addition, our site (Massachusetts General Hospital; MGH) proposes addressing: (1) the contribution of novel biopsychosocial factors in the maintenance of gastroparesis symptoms, and (2) the preliminary efficacy of a cognitive behavioral therapy (CBT) for gastroparesis.