Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment
Pyloric dysfunction is defined as hypertonia or spasm of the pyloric sphincter. The pylorus plays a key role in gastric emptying, but its function remains incompletely understood. Most studies have focused on gastroparesis regardless of the underlying pathophysiology. Few studies have reported pylor...
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| Format: | Article |
| Language: | English |
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Gastroenterology Council for Gut and Liver
2025-05-01
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| Series: | Gut and Liver |
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| Online Access: | http://gutnliver.org/journal/view.html?doi=10.5009/gnl240421 |
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| author | Hee Kyong Na Andrew A. Li Andres Gottfried-Blackmore Alexander J. Podboy Micaela M. Esquivel Abel A. Joseph Linda Nguyen Joo Ha Hwang |
| author_facet | Hee Kyong Na Andrew A. Li Andres Gottfried-Blackmore Alexander J. Podboy Micaela M. Esquivel Abel A. Joseph Linda Nguyen Joo Ha Hwang |
| author_sort | Hee Kyong Na |
| collection | DOAJ |
| description | Pyloric dysfunction is defined as hypertonia or spasm of the pyloric sphincter. The pylorus plays a key role in gastric emptying, but its function remains incompletely understood. Most studies have focused on gastroparesis regardless of the underlying pathophysiology. Few studies have reported pyloric dysfunction in patients with gastroparesis, and the diagnostic and treatment modalities for pyloric dysfunction are not well established. Recently developed diagnostic modalities assessing pyloric function, such as high-resolution antroduodenal manometry and endoluminal functional lumen imaging, are currently being evaluated. A variety of therapeutic interventions targeting the pylorus, including pharmacologic agents, intrapyloric botulinum injection, endoscopic balloon dilation, stent insertion, surgical pyloroplasty, and gastric peroral endoscopic pyloromyotomy, have been proposed. Among these, gastric peroral endoscopic pyloromyotomy has emerged as a novel, minimally invasive therapy with demonstrated efficacy and safety for refractory gastroparesis. This article reviews the pathophysiology of pyloric dysfunction and the potential diagnostic and therapeutic modalities based on the latest literature. |
| format | Article |
| id | doaj-art-be0a96cdfdd74fba9e20ef9395ff4448 |
| institution | Kabale University |
| issn | 1976-2283 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Gastroenterology Council for Gut and Liver |
| record_format | Article |
| series | Gut and Liver |
| spelling | doaj-art-be0a96cdfdd74fba9e20ef9395ff44482025-08-20T03:52:57ZengGastroenterology Council for Gut and LiverGut and Liver1976-22832025-05-0119332734510.5009/gnl240421gnl240421Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and TreatmentHee Kyong Na0Andrew A. Li1Andres Gottfried-Blackmore2Alexander J. Podboy3Micaela M. Esquivel4Abel A. Joseph5Linda Nguyen6Joo Ha Hwang7Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USADepartment of Pharmacology and Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USADivision of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA, USADivision of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USADivision of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USADivision of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USADivision of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USAPyloric dysfunction is defined as hypertonia or spasm of the pyloric sphincter. The pylorus plays a key role in gastric emptying, but its function remains incompletely understood. Most studies have focused on gastroparesis regardless of the underlying pathophysiology. Few studies have reported pyloric dysfunction in patients with gastroparesis, and the diagnostic and treatment modalities for pyloric dysfunction are not well established. Recently developed diagnostic modalities assessing pyloric function, such as high-resolution antroduodenal manometry and endoluminal functional lumen imaging, are currently being evaluated. A variety of therapeutic interventions targeting the pylorus, including pharmacologic agents, intrapyloric botulinum injection, endoscopic balloon dilation, stent insertion, surgical pyloroplasty, and gastric peroral endoscopic pyloromyotomy, have been proposed. Among these, gastric peroral endoscopic pyloromyotomy has emerged as a novel, minimally invasive therapy with demonstrated efficacy and safety for refractory gastroparesis. This article reviews the pathophysiology of pyloric dysfunction and the potential diagnostic and therapeutic modalities based on the latest literature.http://gutnliver.org/journal/view.html?doi=10.5009/gnl240421pylorus; dysfunction; spasm; gastroparesis; pyloromyotomy |
| spellingShingle | Hee Kyong Na Andrew A. Li Andres Gottfried-Blackmore Alexander J. Podboy Micaela M. Esquivel Abel A. Joseph Linda Nguyen Joo Ha Hwang Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment Gut and Liver pylorus; dysfunction; spasm; gastroparesis; pyloromyotomy |
| title | Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment |
| title_full | Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment |
| title_fullStr | Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment |
| title_full_unstemmed | Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment |
| title_short | Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment |
| title_sort | pyloric dysfunction a review of the mechanisms diagnosis and treatment |
| topic | pylorus; dysfunction; spasm; gastroparesis; pyloromyotomy |
| url | http://gutnliver.org/journal/view.html?doi=10.5009/gnl240421 |
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