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Management of Gastroparesis: Beyond Basics

  • Motility (T Lembo, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion statement

Gastroparesis is defined as the presence of delayed gastric emptying in the absence of mechanical obstruction, with a variety of upper gastrointestinal symptoms. Although measurement of gastric emptying is necessary for the diagnostic labeling, this finding has little impact in terms of explaining the symptom pattern and determining the prognosis and therapeutic approach. Clinical management is based on ruling out of mechanical causes and serum electrolyte imbalances, followed by initial medical treatment with a gastroprokinetic agent in most cases. However, the evidence that these drugs provide substantial symptomatic benefit is weak. Recent attempts to establish efficacy with newer prokinetics, including serotonin-4, motilin, and ghrelin receptor agonists, have seen few successes, but a new group of agents is under evaluation. More recently, also, no benefit was found with treatment with a tricyclic antidepressant in idiopathic gastroparesis. In refractory cases, especially when there is weight loss, invasive therapeutics such as insertion of feeding tubes, intrapyloric injection of botulinum toxin, implantable gastric electrical stimulation, or surgical (partial) gastrectomy are occasionally considered, but there is little evidence of efficacy, and these are not devoid of potentially major complications. Gastroparesis is likely to remain a challenging condition in the clinic in the foreseeable future.

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Conflict of Interest

Jan Tack has received consultancy fees from Alfa Wasserman, GSK, Janssen, Rhythm, Shire, and Theravance, and a research support grant from Shire. Dr. Tack has also received payment for development of educational presentations, including service on speakers’ bureaus, from Janssen and Shire.

Christophe Vanormelingen declares that she has no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Translational Research Center for Gastrointestinal Disorders, University of Leuven, 49 Herestraat, 3000, Leuven, Belgium

    Jan Tack MD, PhD & Christophe Vanormelingen PhD

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  1. Jan Tack MD, PhD
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Correspondence to Jan Tack MD, PhD.

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Tack, J., Vanormelingen, C. Management of Gastroparesis: Beyond Basics. Curr Treat Options Gastro 12, 468–477 (2014). https://doi.org/10.1007/s11938-014-0034-7

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