Beyond The Abstract Sympathomimetic Amine Therapy May Improve Refractory Gastroparesis Similar To Its Effect On Chronic Pelvic Pain--Case Report

Main Category: Women's Health / Gynecology
Also Included In: Urology / Nephrology;  GastroIntestinal / Gastroenterology;  Pain / Anesthetics
Article Date: 10 Dec 2007 - 0:00 PDT

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UroToday.com - A medical condition common in women, not well known by the medical community, manifests with a variety of symptomatology and is related to a defect in the sympathetic nervous system leading to increased capillary permeability. The condition usually manifests as either fluid retention or pain syndrome. Without knowledge of this condition, the cause of the women's complaints are usually found refractory to a variety of treatments. They do, however, respond quickly and effectively to treatment with sympathomimetic amines.

There have been case reports, rather than controlled studies, showing dramatic quick treatment of relief of pelvic pain syndrome, e.g., interstitial cystitis, that have proved refractory to other therapies following the treatment with 10-30mg of sustained release dextroamphetamine sulfate. The authors hypothesized that increased capillary permeability in the bladder allowed absorption of toxins into the bladder wall leading to pain and the dextroamphetamine sulfate corrected the permeability defect.

Some refractory pain syndromes involving the gastrointestinal tract have been reported to improve quickly and dramatically with treatment with sympathomimetic amines, e.g., a case of esophageal pain. A 29-year-old woman with long-term abdominal pain who was diagnosed with gastroparesis but did not respond to traditional therapy was treated with dextroamphetamine sulfate 20 mg/day. After several weeks of treatment, the pain disappeared and she was able to stop all other medications and just remain on the sympathomimetic amine therapy. She has remained free of pain now for over a year. In contrast to case reports of using dextroamphetamine sulfate for interstitial cystitis where there is dramatic relief of pain within a few days, for some reason there seems to be a delay in its efficacy for gastroparesis. Thus, both patient and physician should be more patient when treating gastroparesis and not give up on therapy too soon.

Written by Jerome H. Check, M.D., Ph.D., as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

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