Гастропарез нужно выявлять и лечить

Гастропарез, симптоматическое хроническое заболевание желудка, характеризуется объективными признаками задержки его опорожнения при отсутствии механической обструкции. Гастропарез редко документируется в обычной клинической практике. Данное заболевание обычно подозревают, исследуют и диагностируют у пациентов с синдромом интенсивной и продолжительной тошноты, рвоты, раннего чувства насыщения, боли в эпигастрии, которые возникают в результате ряда мышечных, нервных или ритмических нарушений в работе желудка. Хотя задержка опорожнения желудка является определяющим признаком гастропареза, другие аспекты нервно-мышечной дисфункции желудка, такие как дезадаптация и висцеральная гиперчувствительность, также могут способствовать появлению симптомов гастропареза. Симптомы гастропареза часто совпадают с симптомами других функциональных заболеваний желудочно-кишечного тракта, включая синдром хронической необъяснимой тошноты и рвоты, синдром циклической рвоты, различные нарушения взаимодействия между кишечником и мозгом и прежде всего функциональную диспепсию. В данной статье представлен обзор различных исследований при гастропарезе с точки зрения моторики желудка. В клинической гастроэнтерологической практике гастропарез считается одним из наиболее сложных состояний, поскольку существуют расхождения в отношении определения, спектра симптомов, диагностики и оптимального терапевтического подхода, особенно в связи с недостаточностью методов лечения с доказанной эффективностью. В статье рассматриваются современные данные по эпидемиологии, этиологическим факторам, патофизиологическим концепциям, а также обосновывается необходимость правильной диагностики гастропареза. Подробно описаны методы лечения функционального гастропареза – диетотерапия, прокинетики, противорвотные средства и препараты для купирования симптомов. Также представлено обоснование применения прокинетика итоприда и гастропротектора ребамипида.

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