J Neurogastroenterol Motil  
Gastroparesis and Functional Dyspepsia: A Blurring Distinction of Pathophysiology and Treatment
Beom Jin Kim1,2 and Braden Kuo2*
1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea; and 2Gastrointestinal Unit, Center of Neuroenteric Health, Massachusetts General Hospital, Harvard Medical School, Boston, USA
Correspondence to: Braden Kuo, MD, PhD
Gastrointestinal Unit, Center of Neuroenteric Health, 165 Cambridge Street 9th Floor, Boston, MA 02114, USA
Tel: +1-617-724-6038, Fax: +1-617-726-2047, E-mail: BKUO@mgh.harvard.edu
Received: September 28, 2018; Revised: October 26, 2018; Accepted: October 30, 2018; Published online: December 3, 2018.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Gastroparesis and functional dyspepsia are 2 of the most common gastric neuromuscular disorders. These disorders are usually confused, having both similarities and differences. The pathophysiology of these disorders involves abnormal gastric motility, visceral hypersensitivity, mucosal inflammation, and various cellular changes. Both disorders have similar symptoms such as epigastric pain or discomfort, early satiety, and bloating. If patients suspected of having either gastroparesis or functional dyspepsia present with upper gastrointestinal symptoms, they should undergo upper endoscopy to exclude an alternative organic cause. Although the gastric emptying rate is frequently assessed during the clinical workup of patients with gastroparesis or functional dyspepsia, the correlation between gastric emptying and the symptoms is generally poor. Once the diagnosis of gastroparesis or functional dyspepsia is made, treatment should focus on the predominant symptom. Recently, various treatment modalities have been developed and validated. Prokinetic agents are generally used as treatment for both gastroparesis and functional dyspepsia. Acid-suppressive therapy, Helicobacter pylori eradication, and use of drugs that enhance gastric accommodation are employed for functional dyspepsia. Psychoactive drugs are also effective in symptom control. For gastroparesis, antiemetic agents, ghrelin receptor agonists, and serotonergic agents are used aside from prokinetic agents. Acupuncture and gastric electrical stimulation can be attempted. In severe cases, endoscopic and surgical interventions are considered for symptom control.
Keywords: Dyspepsia; Gastroparesis; Pathophysiology; Therapeutics


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