Gastrointestinal dysmotility

TK NK2r antagonists showed interesting activities in preclinical models of depression, anxiety, asthma, gastrointestinal dysmotility and hypersensitivity, and urinary incontinence [1,3]. In clinical, NK2r antagonists antagonize NKA-induced bronchoconstriction and NKA-induced intestinal dysmotility. However, a pilot trial in asthma failed to show any clinical benefit by... 

Wang X, Gong Z, Wu K, Wang B, Yuang Y Gastrointestinal dysmotility in patients with acute pancreatitis. J Gastroenterol Hepatol 2003 18 57-62. 

PEM is one of the most frequent cancer-associated syndromes. This complex disorder usually affects several areas of the CNS. Cerebellar and brain stem disorders, as well as limbic encephalitis, are the most common clinical presentations of PEM [31, 32], Focal involvement of the sensorimotor cortex has been described in a few cases [33], and PEM may manifest as epileptic seizures or epilepsia partialis continua [33, 34], or as extrapyramidal symptoms [35], Two-thirds of the patients are affected in both the CNS and the peripheral nervous system. The predominant feature in more than half of these is SN [32, 36], hence the commonly used term is PEM/SN. Autonomic dysfunction is common in PEM/SN patients [36], often presenting as gastrointestinal dysmotility [37]. 

Paraneoplastic autonomic neuropathy is primarily seen with SCLC [103]. Lymphoma, non-small cell lung cancer, and ovarian cancer are also associated with autonomic disturbances [104]. Autonomic dysfunction affects 23-30% of Hu antibody positive patients [36, 98] and is the predominant symptom at presentation in up to 9% of the patients [90]. The onset of symptoms is usually subacute. A prominent clinical manifestation in patients with paraneoplastic autonomic neuropathy is gastrointestinal dysmotility and intestinal pseudo-obstruction, which can occur as part of the PEM/SN syndrome or as the sole symptom of Hu antibody related PNS. Ortostatic hypotension and erectile dysfunction are other common features [37, 105, 106], Autonomic neuropathy is also commonly associated with the CRMP-5 antibody and have been detected in more than 30% of CRMP-5 antibody positive patients [30], Inflammation in autonomic ganglia and infiltration of B and T cells have been demonstrated at autopsy [107], and Hu antibodies have been shown to induce neuronal apoptosis in cultured myenteric neurons [105],... 

These symptoms were possibly related to the use of ecstasy, but it is also possible that a corrosive additive in the ecstasy was responsible. Ecstasy can cause gastrointestinal dysmotility, which could have resulted in esophageal rupture. 

Tomomasa T, Miyazawa R, Kato M, Hoshino M, Tabata M, Kaneko H, Suzuki M, Kobayashi T, Morikawa A. Prolonged gastrointestinal dysmotility in a patient with hemophagocytic lymphohistiocytosis treated with vincristine. Dig Dis Sci 1999 44(9) 1755-7. 

Radionuclide gastric emptying can be used to evaluate patients presenting with symptoms of gastropa-resis and diffuse gastrointestinal dysmotility. Gas-... 

Nausea and vomiting may be manifestations of a wide variety of conditions, including adverse effects from medications systemic disorders or infections pregnancy vestibular dysfunction central nervous system infection or increased pressure peritonitis hepatobiliary disorders radiation or chemotherapy and gastrointestinal obstruction, dysmotility, or infections. 

Most patients with systemic sclerosis have Raynaud s phenomenon, where the digits tarn white, followed by a bluish color, which is then followed by reddening in response to an appropriate stimulus. Usually the precipitating event is cold temperatare or emotion. The pallor is due to vasospasm, the bluish color is from ischemia, and the reddish color is caused by a reactive hyperemia. Raynaud s phenomenon is a common manifestation of other syndromes, and most patients with Raynaud s phenomenon do not have systemic sclerosis. Approximately 50% to 80% of patients with systemic sclerosis have gastrointestinal symptoms, and 75% to 90% of patients have esophageal dysmotility. 

Pseudo-obstruction, a hypomotility or dysmotility disorder of the gastrointestinal tract that is thought to be a neuromuscular disorder of the smooth muscle and/or its innervation, often presents with the symptoms of bowel obstruction. Prolonged dysmotility can result in malnutrition as well as growth failure in children. Primary factors contributing to a risk of malnutrition are anorexia, nausea, vomiting, and obstruction, which may recur over years. Approximately 15% to 30% of patients with pseudo-obstruction require nutrition support with either PN or EN. ... 

Pseudo-obstruction PN is indicated in patients with prolonged dysmotility of the gastrointestinal tract distal to the pylorus, or in patients who cannot grow and gain weight with enteral nutrition alone. 

---