Gastroparesis and Cancer-Related Gastroparesis

  • Mellar P. DavisEmail author
  • Renee Weller
  • Sally Regel
Reference work entry


Gastroparesis is an underrecognized cause of nausea, vomiting, early satiety, postprandial fullness, and weight loss in advanced cancer. Causes for gastroparesis include reduced pyloric compliance and mobility, impaired duodenal contractions, widespread neuropathy, and selective loss of interstitial cells of Cajal. Patients with cancer may develop gastroparesis because of chemotherapy-induced neuropathy, immunosuppression followed by opportunistic viral infections involving the gastrointestinal tract, procedures such as celiac blocks, paraneoplastic neuropathy or myopathy, and as a sequalae of graft-versus-host disease after allogeneic bone marrow transplant. The symptoms of gastroparesis do not correlate with the degree of impairment observed in gastric emptying studies. Treatment includes prokinetics such as metoclopramide, erythromycin, azithromycin, and domperidone. Symptoms may respond to mirtazapine, granisetron, and acupuncture. Gastric electrical stimulation and pyloromyotomy procedures have been reported to reduce symptoms, but there are no randomized trials to validate either procedure. In those failing to respond to medical management, a percutaneous endoscopy-placed gastric tube for decompression with a jejunal extension feeding tube (PEG-J) can be used to reduce symptoms and provide nutrition.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Palliative CareGeisinger Medical CenterDanvilleUSA

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