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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi u. 46. 1088
  • 2 MTA-SE Molekuláris Medicina Kutatócsoport Budapest
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A gastroparesis a gyomor ürülésének olyan zavara, amely mechanikus elzáródás nélkül jelentkezik. Tünetei között a hányinger, a hányás, a puffadás, a korai teltségérzet és a diszkomfortérzés az elsődlegesek. Súlyos esetekben súlyvesztés, kiszáradás, elektrolitzavarok, alultápláltság is következménye lehet. A gastroparesis eseteinek többsége idiopathiás, emellett az esetek kb. 25–30%-ának hátterében hosszú ideje fennálló diabetes mellitus áll. A diabéteszes gastroparesis a vércukor-beállítást jelentősen megnehezítheti, kezelése jelentős kihívást jelent. A gyakori, kis mennyiségű étkezések és pszichológiai támogatás mellett több gyógyszeres lehetőség is rendelkezésre áll, azonban ezek hatékonysága korlátozott, és meggyőző, randomizált tanulmányok csak kevés esetben állnak rendelkezésre. A szóba jövő szerek között a prokinetikumok (erythromycin, domperidon, metoclopramid) és antiemetikumok (fenotiazinok, szerotonin-antagonisták, butirofenonok) a leginkább elterjedtek. Az újabb, hatékonynak tűnő szerek közül a szerotonin 5-HT4-receptor-agonisták és dopamin D2-receptor-antagonisták alkalmazása jöhet szóba. Botulinum toxin pylorus sphincterbe injektálásával néhány tanulmányban javuló gyomorürülést és a tünetek enyhülését észlelték. Az egyik leghatékonyabb megoldásnak a gyomor elektromos serkentése tűnik, amelynek mind alacsony, mind magas frekvenciájú formája a tüneteket enyhítheti. A gastrostomia/jejunostomia, illetőleg egyéb sebészeti megoldások csak végső esetben merülnek fel.

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