# Subtypes of Gastroparesis

> **NIH NIH U01** · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2020 · $387,500

## Abstract

Project Summary
Understanding subtypes of gastroparesis and the pathophysiology of symptoms associated with
gastroparesis are required before improved treatments can be designed. Our aims are to 1)
define major subtypes of gastroparesis using physiological testing for gastric myoelectrical
activity (GMA), accommodation, and autonomic nervous system function and 2) explore
pathophysiological mechanisms of meal-induced symptoms in patients with gastroparesis and
gastroparesis-like syndromes. Variable depletion of interstitial cells of Cajal (ICCs) creates a
continuum of dysfunction of electrical and contractile activities of the stomach. Physiological
tests to measure gastric emptying, gastric myoelectrical activity (GMA), and gastric
accommodation reflect this continuum of ICC depletion from gastric dysrhythmias and normal
gastric emptying to delays in gastric emptying. Our recent observations revealed two important
subtypes of gastroparesis: 1) obstructive gastroparesis and 2) gastroparesis with postural
orthostatic tachycardia syndrome (POTS). Preliminary studies show positive responses to
pyloric therapies and to fludrocortisone and vitamin D in these subtypes, respectively. The
important physiological differences in these subgroups of gastroparesis provide the rationale for
more precise, individual treatments. Physiological testing during provocative test meals in
symptomatic patients with normal gastric emptying (e.g. chronic unexplained nausea and
vomiting, dysmotility-like dyspepsia, or postprandial distress syndrome) unmasks subtypes with:
1) gastric dysrhythmias or normal 3 cpm GMA and 2) normal or abnormal gastric
accommodation. Our studies will utilize the database of Registry 2 of the Gastroparesis Clinical
Research Consortium which contains extensive physiologic data in patients with idiopathic and
diabetic gastroparesis and in patients with normal gastric emptying and new data from patients
enrolled in the continuation of the Registry. This project will characterize clinically important
subgroups of symptomatic patients with or without gastroparesis, increase our understanding of
the underlying pathophysiology of gastroparesis-associated symptoms, and lead to more
rational therapies based on physiological test results.

## Key facts

- **NIH application ID:** 10001028
- **Project number:** 5U01DK073974-15
- **Recipient organization:** WAKE FOREST UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** KENNETH L KOCH
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $387,500
- **Award type:** 5
- **Project period:** 2006-04-15 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10001028

## Citation

> US National Institutes of Health, RePORTER application 10001028, Subtypes of Gastroparesis (5U01DK073974-15). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10001028. Licensed CC0.

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