Gastric motor dysfunction: Is eosinophilic mural gastritis a causative factor?

Sean T. Martin, Chris G. Collins, James Fitzgibbon, Garry Lee, Eamonn Martin Quigley, Gerald C. O'Sullivan

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Delayed gastric emptying caused either by gastric motor dysfunction or by gastroparesis is a profoundly debilitating disorder. When unresponsive to medical therapy, patients may undergo radical surgery including near-total gastro-oesophageal, with varied symptomatic improvement. We describe two patients who presented with symptoms consistent with gastro-oesophageal reflux, unresponsive to medical management. After fundoplication both developed symptoms of profound gastric motor dysfunction and subsequently proceeded to near-total gastro-oesophageal with symptomatic improvement. Histological examination of both excised gastric specimens revealed eosinophilic mural gastritis. To our knowledge, these are the first cases to demonstrate the association of mural eosinophilia and symptomatic gastric motor dysfunction. We propose that patients with gastric motor dysfunction, refractory to medical management, progress to laparoscopy and mural biopsy before gastrectomy. This would allow histological analysis of the gastric wall, and in the event of a positive finding of mural eosinophilic gastritis would allow a trial of medical therapy that could include an eosinophilic stabilizer such as the leukotriene D4 receptor antagonist montelukast or intravenous corticosteroid therapy, which may alleviate the symptoms.

Original languageEnglish (US)
Pages (from-to)983-986
Number of pages4
JournalEuropean Journal of Gastroenterology and Hepatology
Volume17
Issue number9
DOIs
StatePublished - Sep 1 2005

Keywords

  • Gastric dysmotility
  • Gastroparesis
  • Gastropathy
  • Mural eosinophilia

ASJC Scopus subject areas

  • Gastroenterology

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