Updated Guidelines for Diagnosing and Managing Gastroparesis

In the latest clinical practice guideline published in the October issue of Gastroenterology, the American Gastroenterological Association provides conditional recommendations for the diagnosis and treatment of gastroparesis, a condition characterized by delayed stomach emptying that causes nausea, vomiting, and abdominal discomfort. Dr. Kyle Staller from Massachusetts General Hospital and Harvard Medical School led the effort in reviewing available evidence to formulate these guidelines.

The panel agreed on twelve key recommendations. For suspected gastroparesis, a shift from two-hour gastric emptying testing to four-hour testing is advised, reflecting the importance of accurate diagnosis. Regarding treatment options, the use of metoclopramide and erythromycin as primary therapies is recommended under certain conditions, while other medications such as domperidone, prucalopride, aprepitant, nortriptyline, buspirone, and cannabidiol are not recommended as initial treatments.

Procedural interventions like gastric per-oral endoscopic pyloromyotomy or gastric electrical stimulation are generally not advised for routine use but may be considered for patients unresponsive to medical therapy. There are no current recommendations supporting surgical pyloromyotomy or pyloroplasty.

Dr. Staller emphasized that these guidelines are not strict rules but rather suggestions to aid clinicians and patients in weighing potential benefits and risks based on individual circumstances. The goal remains to tailor treatment plans to each patient's personal goals and medical needs.

This guidance aims to enhance the accuracy of diagnosis and optimize management approaches to improve patient outcomes in gastroparesis.

Source: Medical Xpress