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Medical Management of Gastroparesis: Diet and Medications

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The SAGES Manual of Foregut Surgery

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Abstract

Gastroparesis is characterized by delayed gastric emptying with associated symptoms of nausea, postprandial fullness, bloating, upper abdominal pain, early satiety, and, with more severe disease, vomiting in the absence of mechanical obstruction. The most common causes of gastroparesis are idiopathic, diabetic, and postsurgical. Metoclopramide is the only FDA-approved medication for the treatment of gastroparesis. In patients with diabetic gastroparesis, incretin-based medications (e.g., the amylin analog, pramlintide) and GLP-1 analogs (e.g., exenatide, liraglutide) may delay gastric emptying. The general principles of dietary management are based on measures that optimize gastric emptying (e.g., blenderized, low-fat, low-fiber diet) while meeting the patient’s nutritional requirements. There is still considerable unmet need for the medical management of gastroparesis. Novel pharmacotherapy with prucalopride and relamorelin is promising, and endoscopic or laparoscopic interventions (considered elsewhere in this book) may change the landscape of therapeutic interventions for treatment of gastroparesis.

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References

  1. Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L. Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013;108(1):18–37. quiz 8

    Article  CAS  PubMed  Google Scholar 

  2. Abell TL, Bernstein RK, Cutts T, Farrugia G, Forster J, Hasler WL, et al. Treatment of gastroparesis: a multidisciplinary clinical review. Neurogastroenterol Motil. 2006;18(4):263–83.

    Article  CAS  PubMed  Google Scholar 

  3. Lacy BE, Weiser K. Gastric motility, gastroparesis, and gastric stimulation. Surg Clin North Am. 2005;85(5):967–87, vi-vii.

    Article  PubMed  Google Scholar 

  4. Bredenoord AJ, Chial HJ, Camilleri M, Mullan BP, Murray JA. Gastric accommodation and emptying in evaluation of patients with upper gastrointestinal symptoms. Clin Gastroenterol Hepatol. 2003;1(4):264–72.

    Article  PubMed  Google Scholar 

  5. Tack J, Bisschops R, Sarnelli G. Pathophysiology and treatment of functional dyspepsia. Gastroenterology. 2004;127(4):1239–55.

    Google Scholar 

  6. Jung HK, Choung RS, Locke GR, 3rd, Schleck CD, Zinsmeister AR, Szarka LA, et al. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology. 2009;136(4):1225–33.

    Google Scholar 

  7. Talley NJ, Locke GR 3rd, Lahr BD, Zinsmeister AR, Tougas G, Ligozio G, et al. Functional dyspepsia, delayed gastric emptying, and impaired quality of life. Gut. 2006;55(7):933–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Maleki D, Locke GR 3rd, Camilleri M, Zinsmeister AR, Yawn BP, Leibson C, et al. Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med. 2000;160(18):2808–16.

    Article  CAS  PubMed  Google Scholar 

  9. Choung RS, Locke GR 3rd, Schleck CD, Zinsmeister AR, Melton LJ 3rd, Talley NJ. Risk of gastroparesis in subjects with type 1 and 2 diabetes in the general population. Am J Gastroenterol. 2012;107(1):82–8.

    Article  PubMed  Google Scholar 

  10. Nguyen LA, Snape WJ Jr. Clinical presentation and pathophysiology of gastroparesis. Gastroenterol Clin N Am. 2015;44(1):21–30.

    Article  Google Scholar 

  11. Camilleri M, Bharucha AE, Farrugia G. Epidemiology, mechanisms, and management of diabetic gastroparesis. Clin Gastroenterol Hepatol. 2011;9(1):5–12. quiz e7.

    Google Scholar 

  12. Kindt S, Tack J. Impaired gastric accommodation and its role in dyspepsia. Gut. 2006;55(12):1685–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Camilleri M, Malagelada JR, Brown ML, Becker G, Zinsmeister AR. Relation between antral motility and gastric emptying of solids and liquids in humans. Am J Phys. 1985;249(5 Pt 1):G580–5.

    CAS  Google Scholar 

  14. Camilleri M. Novel diet, drugs, and gastric interventions for gastroparesis. Clin Gastroenterol Hepatol. 2016;14(8):1072–80.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kelly KA. Gastric emptying of liquids and solids: roles of proximal and distal stomach. Am J Phys. 1980;239(2):G71–6.

    CAS  Google Scholar 

  16. Siegel JA, Urbain JL, Adler LP, Charkes ND, Maurer AH, Krevsky B, et al. Biphasic nature of gastric emptying. Gut. 1988;29(1):85–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Camilleri M, Grover M, Farrugia G. What are the important subsets of gastroparesis? Neurogastroenterol Motil. 2012;24(7):597–603.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Soykan I, Sivri B, Sarosiek I, Kiernan B, McCallum RW. Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis. Dig Dis Sci. 1998;43(11):2398–404.

    Article  CAS  PubMed  Google Scholar 

  19. Parkman HP, Yates K, Hasler WL, Nguyen L, Pasricha PJ, Snape WJ, et al. Similarities and differences between diabetic and idiopathic gastroparesis. Clin Gastroenterol Hepatol. 2011;9(12):1056–64. quiz e133-4.

    Google Scholar 

  20. Wood JD, Alpers DH, Andrews PL. Fundamentals of neurogastroenterology. Gut. 1999;45(Suppl 2):Ii6–ii16.

    Google Scholar 

  21. Gillespie JS, Maxwell JD. Adrenergic innervation of sphincteric and nonsphincteric smooth muscle in the rat intestine. J Histochem Cytochem. 1971;19(11):676–81.

    Article  CAS  PubMed  Google Scholar 

  22. Costa M, Gabella G. Adrenergic innervation of the alimentary canal. Zeitschrift fur Zellforschung und mikroskopische. Anatomie (Vienna, Austria : 1948). 1971;122(3):357–77.

    CAS  Google Scholar 

  23. Ishiguchi T, Nakajima M, Sone H, Tada H, Kumagai AK, Takahashi T. Gastric distension-induced pyloric relaxation: central nervous system regulation and effects of acute hyperglycaemia in the rat. J Physiol. 2001;533(Pt 3):801–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Oh JH, Pasricha PJ. Recent advances in the pathophysiology and treatment of gastroparesis. J Neurogastroenterol Motil. 2013;19(1):18–24.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Camilleri M, Brown ML, Malagelada JR. Relationship between impaired gastric emptying and abnormal gastrointestinal motility. Gastroenterology. 1986;91(1):94–9.

    Article  CAS  PubMed  Google Scholar 

  26. Feldman M, Corbett DB, Ramsey EJ, Walsh JH, Richardson CT. Abnormal gastric function in longstanding, insulin-dependent diabetic patients. Gastroenterology. 1979;77(1):12–7.

    PubMed  Google Scholar 

  27. Forster J, Damjanov I, Lin Z, Sarosiek I, Wetzel P, McCallum RW. Absence of the interstitial cells of Cajal in patients with gastroparesis and correlation with clinical findings. J Gastrointest Surg. 2005;9(1):102–8.

    Article  PubMed  Google Scholar 

  28. Iwasaki H, Kajimura M, Osawa S, Kanaoka S, Furuta T, Ikuma M, et al. A deficiency of gastric interstitial cells of Cajal accompanied by decreased expression of neuronal nitric oxide synthase and substance P in patients with type 2 diabetes mellitus. J Gastroenterol. 2006;41(11):1076–87.

    Article  CAS  PubMed  Google Scholar 

  29. Feldman M, Richardson CT, Fordtran JS. Effect of sham feeding on gastric acid secretion in healthy subjects and duodenal ulcer patients: evidence for increased basal vagal tone in some ulcer patients. Gastroenterology. 1980;79(5 Pt 1):796–800.

    CAS  PubMed  Google Scholar 

  30. Grover M, Farrugia G, Lurken MS, Bernard CE, Faussone-Pellegrini MS, Smyrk TC, et al. Cellular changes in diabetic and idiopathic gastroparesis. Gastroenterology. 2011;140(5):1575–85.e8.

    Google Scholar 

  31. Farrugia G. Interstitial cells of Cajal in health and disease. Neurogastroenterol Motil. 2008;20(Suppl 1):54–63.

    Article  PubMed  Google Scholar 

  32. Sanders KM, Koh SD, Ward SM. Interstitial cells of cajal as pacemakers in the gastrointestinal tract. Annu Rev Physiol. 2006;68:307–43.

    Article  CAS  PubMed  Google Scholar 

  33. Barajas-Lopez C, Berezin I, Daniel EE, Huizinga JD. Pacemaker activity recorded in interstitial cells of Cajal of the gastrointestinal tract. Am J Phys. 1989;257(4 Pt 1):C830–5.

    Article  CAS  Google Scholar 

  34. Shah V, Lyford G, Gores G, Farrugia G. Nitric oxide in gastrointestinal health and disease. Gastroenterology. 2004;126(3):903–13.

    Article  CAS  PubMed  Google Scholar 

  35. He CL, Soffer EE, Ferris CD, Walsh RM, Szurszewski JH, Farrugia G. Loss of interstitial cells of cajal and inhibitory innervation in insulin-dependent diabetes. Gastroenterology. 2001;121(2):427–34.

    Article  CAS  PubMed  Google Scholar 

  36. Zarate N, Mearin F, Wang XY, Hewlett B, Huizinga JD, Malagelada JR. Severe idiopathic gastroparesis due to neuronal and interstitial cells of Cajal degeneration: pathological findings and management. Gut. 2003;52(7):966–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Dishy V, Cohen Pour M, Feldman L, Naftali T, Baumer M, Efrati S, et al. The effect of sildenafil on gastric emptying in patients with end-stage renal failure and symptoms of gastroparesis. Clin Pharmacol Ther. 2004;76(3):281–6.

    Article  CAS  PubMed  Google Scholar 

  38. Cipriani G, Gibbons SJ, Kashyap PC, Farrugia G. Intrinsic gastrointestinal macrophages: their phenotype and role in gastrointestinal motility. Cell Mol Gastroenterol Hepatol. 2016;2(2):120-30.e1.

    Article  Google Scholar 

  39. Bernard CE, Gibbons SJ, Mann IS, Froschauer L, Parkman HP, Harbison S, et al. Association of low numbers of CD206-positive cells with loss of ICC in the gastric body of patients with diabetic gastroparesis. Neurogastroenterol Motil. 2014;26(9):1275–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Vella A, Lee JS, Camilleri M, Szarka LA, Burton DD, Zinsmeister AR, et al. Effects of pramlintide, an amylin analogue, on gastric emptying in type 1 and 2 diabetes mellitus. Neurogastroenterol Motil. 2002;14(2):123–31.

    Article  CAS  PubMed  Google Scholar 

  41. Drucker DJ, Nauck MA. The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet. 2006;368(9548):1696–705.

    Article  CAS  PubMed  Google Scholar 

  42. Imeryuz N, Yegen BC, Bozkurt A, Coskun T, Villanueva-Penacarrillo ML, Ulusoy NB. Glucagon-like peptide-1 inhibits gastric emptying via vagal afferent-mediated central mechanisms. Am J Phys. 1997;273(4 Pt 1):G920–7.

    CAS  Google Scholar 

  43. Bharucha AE, Camilleri M, Forstrom LA, Zinsmeister AR. Relationship between clinical features and gastric emptying disturbances in diabetes mellitus. Clin Endocrinol. 2009;70(3):415–20.

    Article  Google Scholar 

  44. Holzapfel A, Festa A, Stacher-Janotta G, Bergmann H, Shnawa N, Brannath W, et al. Gastric emptying in type II (non-insulin-dependent) diabetes mellitus before and after therapy readjustment: no influence of actual blood glucose concentration. Diabetologia. 1999;42(12):1410–2.

    Article  CAS  PubMed  Google Scholar 

  45. Fraser R, Horowitz M, Dent J. Hyperglycaemia stimulates pyloric motility in normal subjects. Gut. 1991;32(5):475–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Fraser RJ, Horowitz M, Maddox AF, Harding PE, Chatterton BE, Dent J. Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1990;33(11):675–80.

    Article  CAS  PubMed  Google Scholar 

  47. Ogorek CP, Davidson L, Fisher RS, Krevsky B. Idiopathic gastroparesis is associated with a multiplicity of severe dietary deficiencies. Am J Gastroenterol. 1991;86(4):423–8.

    CAS  PubMed  Google Scholar 

  48. Parkman HP, Yates KP, Hasler WL, Nguyan L, Pasricha PJ, Snape WJ, et al. Dietary intake and nutritional deficiencies in patients with diabetic or idiopathic gastroparesis. Gastroenterology. 2011;141(2):486–98, 98.e1-7.

    Article  CAS  PubMed  Google Scholar 

  49. Bouras EP, Scolapio JS. Gastric motility disorders: management that optimizes nutritional status. J Clin Gastroenterol. 2004;38(7):549–57.

    Article  PubMed  Google Scholar 

  50. Olausson EA, Storsrud S, Grundin H, Isaksson M, Attvall S, Simren M. A small particle size diet reduces upper gastrointestinal symptoms in patients with diabetic gastroparesis: a randomized controlled trial. Am J Gastroenterol. 2014;109(3):375–85.

    Article  CAS  PubMed  Google Scholar 

  51. Abdalla SM, Kalra G, Moshiree B. Motility evaluation in the patient with inflammatory bowel disease. Gastrointest Endosc Clin N Am. 2016;26(4):719–38.

    Article  PubMed  Google Scholar 

  52. Camilleri M. Appraisal of medium- and long-term treatment of gastroparesis and chronic intestinal dysmotility. Am J Gastroenterol. 1994;89(10):1769–74.

    CAS  PubMed  Google Scholar 

  53. Scott AM, Kellow JE, Eckersley GM, Nolan JM, Jones MP. Cigarette smoking and nicotine delay postprandial mouth-cecum transit time. Dig Dis Sci. 1992;37(10):1544–7.

    Article  CAS  PubMed  Google Scholar 

  54. Pfeiffer A, Hogl B, Kaess H. Effect of ethanol and commonly ingested alcoholic beverages on gastric emptying and gastrointestinal transit. Clin Investig. 1992;70(6):487–91.

    Article  CAS  PubMed  Google Scholar 

  55. Sanaka M, Anjiki H, Tsutsumi H, Abe K, Kawakami T, Saitoh M, et al. Effect of cigarette smoking on gastric emptying of solids in Japanese smokers: a crossover study using the 13C-octanoic acid breath test. J Gastroenterol. 2005;40(6):578–82.

    Article  PubMed  Google Scholar 

  56. Fontana RJ, Barnett JL. Jejunostomy tube placement in refractory diabetic gastroparesis: a retrospective review. Am J Gastroenterol. 1996;91(10):2174–8.

    CAS  PubMed  Google Scholar 

  57. Parkman HP, Hasler WL, Fisher RS. American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis. Gastroenterology. 2004;127(5):1592–622.

    Article  PubMed  Google Scholar 

  58. Karamanolis G, Tack J. Nutrition and motility disorders. Best Pract Res Clin Gastroenterol. 2006;20(3):485–505.

    Article  CAS  PubMed  Google Scholar 

  59. Lewis K, Alqahtani Z, McIntyre L, Almenawer S, Alshamsi F, Rhodes A, et al. The efficacy and safety of prokinetic agents in critically ill patients receiving enteral nutrition: a systematic review and meta-analysis of randomized trials. Crit Care. 2016;20(1):259.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Sturm A, Holtmann G, Goebell H, Gerken G. Prokinetics in patients with gastroparesis: a systematic analysis. Digestion. 1999;60(5):422–7.

    Article  CAS  PubMed  Google Scholar 

  61. Richards RD, Davenport K, McCallum RW. The treatment of idiopathic and diabetic gastroparesis with acute intravenous and chronic oral erythromycin. Am J Gastroenterol. 1993;88(2):203–7.

    CAS  PubMed  Google Scholar 

  62. Pasricha PJ, Pehlivanov N, Sugumar A, Jankovic J. Drug insight: from disturbed motility to disordered movement--a review of the clinical benefits and medicolegal risks of metoclopramide. Nat Clin Pract Gastroenterol Hepatol. 2006;3(3):138–48.

    Article  CAS  PubMed  Google Scholar 

  63. Rao AS, Camilleri M. Review article: metoclopramide and tardive dyskinesia. Aliment Pharmacol Ther. 2010;31(1):11–9.

    Article  CAS  PubMed  Google Scholar 

  64. Wijemanne S, Jankovic J, Evans RW. Movement disorders from the use of metoclopramide and other Antiemetics in the treatment of migraine. Headache. 2016;56(1):153–61.

    Article  PubMed  Google Scholar 

  65. Hejazi RA, McCallum RW, Sarosiek I. Prokinetics in diabetic gastroparesis. Curr Gastroenterol Rep. 2012;14(4):297–305.

    Google Scholar 

  66. Parkman HP, Carlson MR, Gonyer D. Metoclopramide nasal spray reduces symptoms of gastroparesis in women, but not men, with diabetes: results of a phase 2B randomized study. Clin Gastroenterol Hepatol. 2015;13(7):1256-63.e1.

    Article  CAS  Google Scholar 

  67. van Noord C, Dieleman JP, van Herpen G, Verhamme K, Sturkenboom MC. Domperidone and ventricular arrhythmia or sudden cardiac death: a population-based case-control study in the Netherlands. Drug Saf. 2010;33(11):1003–14.

    Article  PubMed  Google Scholar 

  68. Marzi M, Weitz D, Avila A, Molina G, Caraballo L, Piskulic L. Cardiac adverse effects of domperidone in adult patients: a systematic review. Rev Med Chil. 2015;143(1):14–21.

    Article  PubMed  Google Scholar 

  69. Schey R, Saadi M, Midani D, Roberts AC, Parupalli R, Parkman HP. Domperidone to treat symptoms of gastroparesis: benefits and side effects from a large single-center cohort. Dig Dis Sci. 2016;61:3545.

    Article  CAS  PubMed  Google Scholar 

  70. Sanger GJ, Wang Y, Hobson A, Broad J. Motilin: towards a new understanding of the gastrointestinal neuropharmacology and therapeutic use of motilin receptor agonists. Br J Pharmacol. 2013;170(7):1323–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Broad J, Takahashi N, Tajimi M, Sudo M, Goralczyk A, Parampalli U, et al. RQ-00201894: a motilin receptor agonist causing long-lasting facilitation of human gastric cholinergically-mediated contractions. J Pharmacol Sci. 2016;130(2):60–5.

    Article  CAS  PubMed  Google Scholar 

  72. Coulie B, Tack J, Peeters T, Janssens J. Involvement of two different pathways in the motor effects of erythromycin on the gastric antrum in humans. Gut. 1998;43(3):395–400.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Larson JM, Tavakkoli A, Drane WE, Toskes PP, Moshiree B. Advantages of azithromycin over erythromycin in improving the gastric emptying half-time in adult patients with gastroparesis. J Neurogastroenterol Motil. 2010;16(4):407–13.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Ray WA, Murray KT, Meredith S, Narasimhulu SS, Hall K, Stein CM. Oral erythromycin and the risk of sudden death from cardiac causes. N Engl J Med. 2004;351(11):1089–96.

    Article  CAS  PubMed  Google Scholar 

  75. Moshiree B, McDonald R, Hou W, Toskes PP. Comparison of the effect of azithromycin versus erythromycin on antroduodenal pressure profiles of patients with chronic functional gastrointestinal pain and gastroparesis. Dig Dis Sci. 2010;55(3):675–83.

    Article  CAS  PubMed  Google Scholar 

  76. Thielemans L, Depoortere I, Perret J, Robberecht P, Liu Y, Thijs T, et al. Desensitization of the human motilin receptor by motilides. J Pharmacol Exp Ther. 2005;313(3):1397–405.

    Article  CAS  PubMed  Google Scholar 

  77. Florencia Carbone AR, Andrews CN, Holvoet L, Lukas VOTV, Bisschops R, Caenepeel P, Arts J, Athanasios P, Tack J. A controlled cross-over trial shows benefit of Prucalopride for symptom control and gastric emptying enhancement in idiopathic gastroparesis. Gastroenterology. 2016;150(4 Supplement 1):S-S1271.

    Google Scholar 

  78. Goldberg M, Li YP, Johanson JF, Mangel AW, Kitt M, Beattie DT, et al. Clinical trial: the efficacy and tolerability of velusetrag, a selective 5-HT4 agonist with high intrinsic activity, in chronic idiopathic constipation - a 4-week, randomized, double-blind, placebo-controlled, dose-response study. Aliment Pharmacol Ther. 2010;32(9):1102–12.

    Article  CAS  PubMed  Google Scholar 

  79. Manini ML, Camilleri M, Goldberg M, Sweetser S, McKinzie S, Burton D, et al. Effects of Velusetrag (TD-5108) on gastrointestinal transit and bowel function in health and pharmacokinetics in health and constipation. Neurogastroenterol Motil. 2010;22(1):42–9, e7-8.

    CAS  PubMed  Google Scholar 

  80. Shin A, Acosta A, Camilleri M, Boldingh A, Burton D, Ryks M, et al. A randomized trial of 5-hydroxytryptamine4-receptor agonist, YKP10811, on colonic transit and bowel function in functional constipation. Clin Gastroenterol Hepatol. 2015;13(4):701–8.e1.

    Article  CAS  PubMed  Google Scholar 

  81. Tack J, Depoortere I, Bisschops R, Verbeke K, Janssens J, Peeters T. Influence of ghrelin on gastric emptying and meal-related symptoms in idiopathic gastroparesis. Aliment Pharmacol Ther. 2005;22(9):847–53.

    Article  CAS  PubMed  Google Scholar 

  82. Shin A, Camilleri M, Busciglio I, Burton D, Stoner E, Noonan P, et al. Randomized controlled phase Ib study of ghrelin agonist, RM-131, in type 2 diabetic women with delayed gastric emptying: pharmacokinetics and pharmacodynamics. Diabetes Care. 2013;36(1):41–8.

    Article  CAS  PubMed  Google Scholar 

  83. Shin A, Camilleri M, Busciglio I, Burton D, Smith SA, Vella A, et al. The ghrelin agonist RM-131 accelerates gastric emptying of solids and reduces symptoms in patients with type 1 diabetes mellitus. Clin Gastroenterol Hepatol. 2013;11(11):1453–9.e4.

    Article  CAS  Google Scholar 

  84. Nelson AD, Camilleri M, Acosta A, Busciglio I, Linker Nord S, Boldingh A, et al. Effects of ghrelin receptor agonist, relamorelin, on gastric motor functions and satiation in healthy volunteers. Neurogastroenterol Motil. 2016;28(11):1705–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Lembo A, Camilleri M, McCallum R, Sastre R, Breton C, Spence S, et al. Relamorelin reduces vomiting frequency and severity and accelerates gastric emptying in adults with diabetic gastroparesis. Gastroenterology. 2016;151(1):87–96.e6.

    Article  CAS  PubMed  Google Scholar 

  86. Rojas C, Slusher BS. Pharmacological mechanisms of 5-HT(3) and tachykinin NK(1) receptor antagonism to prevent chemotherapy-induced nausea and vomiting. Eur J Pharmacol. 2012;684(1-3):1–7.

    Article  CAS  PubMed  Google Scholar 

  87. Zhang Y, Yang Y, Zhang Z, Fang W, Kang S, Luo Y, et al. Neurokinin-1 receptor antagonist-based triple regimens in preventing chemotherapy-induced nausea and vomiting: a network meta-analysis. J Natl Cancer Inst. 2017;109(2):djw217.

    Article  CAS  PubMed  Google Scholar 

  88. Pasricha PJYK, Sarosiek I, et al. Aprepitant for symptoms of gastroparesis and related disorders: the APRON randomized clinical trial. Am J Gastroenterol. 2016;111:S480–1.

    Article  Google Scholar 

  89. Chong K, Dhatariya K. A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant. Nat Rev Endocrinol. 2009;5(5):285–8.

    Article  PubMed  Google Scholar 

  90. Fahler J, Wall GC, Leman BI. Gastroparesis-associated refractory nausea treated with aprepitant. Ann Pharmacother. 2012;46(12):e38.

    Article  PubMed  Google Scholar 

  91. Prakash C, Clouse RE. Cyclic vomiting syndrome in adults: clinical features and response to tricyclic antidepressants. Am J Gastroenterol. 1999;94(10):2855–60.

    Article  CAS  PubMed  Google Scholar 

  92. Sawhney MS, Prakash C, Lustman PJ, Clouse RE. Tricyclic antidepressants for chronic vomiting in diabetic patients. Dig Dis Sci. 2007;52(2):418–24.

    Article  CAS  PubMed  Google Scholar 

  93. Parkman HP, Van Natta ML, Abell TL, McCallum RW, Sarosiek I, Nguyen L, et al. Effect of nortriptyline on symptoms of idiopathic gastroparesis: the NORIG randomized clinical trial. JAMA. 2013;310(24):2640–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Kim SW, Shin IS, Kim JM, Kang HC, Mun JU, Yang SJ, et al. Mirtazapine for severe gastroparesis unresponsive to conventional prokinetic treatment. Psychosomatics. 2006;47(5):440–2.

    Article  PubMed  Google Scholar 

  95. Johnstone M, Buddhdev P, Peter M, Diggory R. Mirtazapine: a solution for postoperative gastroparesis? BMJ Case Rep. 2009;2009.

    Google Scholar 

  96. Gooden JY, Takahashi PY. Mirtazapine treatment of diabetic gastroparesis as a novel method to reduce tube-feed residual: a case report. J Med Case Rep. 2013;7:38.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Song J, Lin N, Tian F, Li Y, Li Y. Successful treatment of gastroparesis with the antidepressant mirtazapine: a case report. J Nippon Medical School Nippon Ika Daigaku Zasshi. 2014;81(6):392–4.

    Article  Google Scholar 

  98. Kundu S, Rogal S, Alam A, Levinthal DJ. Rapid improvement in post-infectious gastroparesis symptoms with mirtazapine. World J Gastroenterol. 2014;20(21):6671–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  99. Anttila SA, Leinonen EV. A review of the pharmacological and clinical profile of mirtazapine. CNS Drug Rev. 2001;7(3):249–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  100. Yin J, Song J, Lei Y, Xu X, Chen JD. Prokinetic effects of mirtazapine on gastrointestinal transit. Am J Physiol Gastrointest Liver Physiol. 2014;306(9):G796–801.

    Article  CAS  PubMed  Google Scholar 

  101. Jeong ID, Camilleri M, Shin A, Iturrino J, Boldingh A, Busciglio I, et al. A randomised, placebo-controlled trial comparing the effects of tapentadol and oxycodone on gastrointestinal and colonic transit in healthy humans. Aliment Pharmacol Ther. 2012;35(9):1088–96.

    CAS  PubMed  Google Scholar 

  102. Maurer AH, Krevsky B, Knight LC, Brown K. Opioid and opioid-like drug effects on whole-gut transit measured by scintigraphy. J Nucl Med. 1996;37(5):818–22.

    CAS  PubMed  Google Scholar 

  103. Dursteler C, Mases A, Fernandez V, Pol O, Puig MM. Interaction between tramadol and two anti-emetics on nociception and gastrointestinal transit in mice. Eur J Pain. 2006;10(7):629–38.

    Article  CAS  PubMed  Google Scholar 

  104. James AN, Ryan JP, Parkman HP. Inhibitory effects of botulinum toxin on pyloric and antral smooth muscle. Am J Physiol Gastrointest Liver Physiol. 2003;285(2):G291–7.

    Article  CAS  PubMed  Google Scholar 

  105. Miller LS, Szych GA, Kantor SB, Bromer MQ, Knight LC, Maurer AH, et al. Treatment of idiopathic gastroparesis with injection of botulinum toxin into the pyloric sphincter muscle. Am J Gastroenterol. 2002;97(7):1653–60.

    Article  CAS  PubMed  Google Scholar 

  106. Ezzeddine D, Jit R, Katz N, Gopalswamy N, Bhutani MS. Pyloric injection of botulinum toxin for treatment of diabetic gastroparesis. Gastrointest Endosc. 2002;55(7):920–3.

    Article  PubMed  Google Scholar 

  107. Lacy BE, Zayat EN, Crowell MD, Schuster MM. Botulinum toxin for the treatment of gastroparesis: a preliminary report. Am J Gastroenterol. 2002;97(6):1548–52.

    Article  CAS  PubMed  Google Scholar 

  108. Bromer MQ, Friedenberg F, Miller LS, Fisher RS, Swartz K, Parkman HP. Endoscopic pyloric injection of botulinum toxin a for the treatment of refractory gastroparesis. Gastrointest Endosc. 2005;61(7):833–9.

    Article  PubMed  Google Scholar 

  109. Coleski R, Anderson MA, Hasler WL. Factors associated with symptom response to pyloric injection of botulinum toxin in a large series of gastroparesis patients. Dig Dis Sci. 2009;54(12):2634–42.

    Article  PubMed  Google Scholar 

  110. Friedenberg FK, Palit A, Parkman HP, Hanlon A, Nelson DB. Botulinum toxin a for the treatment of delayed gastric emptying. Am J Gastroenterol. 2008;103(2):416–23.

    Article  CAS  PubMed  Google Scholar 

  111. Arts J, Holvoet L, Caenepeel P, Bisschops R, Sifrim D, Verbeke K, et al. Clinical trial: a randomized-controlled crossover study of intrapyloric injection of botulinum toxin in gastroparesis. Aliment Pharmacol Ther. 2007;26(9):1251–8.

    Article  CAS  PubMed  Google Scholar 

  112. Wang CP, Kao CH, Chen WK, Lo WY, Hsieh CL. A single-blinded, randomized pilot study evaluating effects of electroacupuncture in diabetic patients with symptoms suggestive of gastroparesis. J Altern Complement Med. 2008;14(7):833–9.

    Article  PubMed  Google Scholar 

  113. Camilleri M. Clinical practice. Diabetic gastroparesis. N Engl J Med. 2007;356:820–9.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We thank Mrs. Cindy Stanislav for excellent secretarial assistance.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

    Deepti Jacob & Michael Camilleri

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  1. Deepti Jacob
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  2. Michael Camilleri
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Correspondence to Michael Camilleri .

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  1. University of Alabama at Birmingham , Birmingham, AL, USA

    Jayleen Grams

  2. The Ohio State University, Columbus, OH, USA

    Kyle A. Perry

  3. Brigham and Women’s Hospital, Boston, MA, USA

    Ali Tavakkoli

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Jacob, D., Camilleri, M. (2019). Medical Management of Gastroparesis: Diet and Medications. In: Grams, J., Perry, K., Tavakkoli, A. (eds) The SAGES Manual of Foregut Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-96122-4_69

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  • DOI: https://doi.org/10.1007/978-3-319-96122-4_69

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