Last update:
18-Feb-2025

Gastroparesis (Gp) is a chronic disorder characterized by delayed gastric emptying in the absence of mechanical obstruction, significantly impacting the quality of life in affected individuals. The underlying pathophysiology of Gp involves neuromuscular abnormalities affecting gastric motor function, with observed reductions in interstitial cells of Cajal. The diagnostic landscape encompasses Technetium-99 scintigraphy, considered the gold standard despite mild radiation risk. The promising wireless motility capsule and 13C breath testing, utilizing 13C acid octanoic and 13C Spirulina platensis kits approved by the Food and Drug Administration, emerge as valid and safe alternatives. Therapeutic approaches in Gp are tailored to its clinical severity. For mild-to-moderate cases, dietary modifications and prokinetic agents often prove effective in alleviating symptoms. While metoclopramide holds FDA approval for Gp, the exploration of both older and newer prokinetics and antiemetics remains a viable consideration, offering a nuanced approach to treatment. For drug-unresponsive Gp patients, a spectrum of alternative strategies is available, including gastric per-oral endoscopic myotomy (G-POEM), gastric electrical stimulation, or surgical interventions, offering a multifaceted approach to the complex and challenging management of this condition.

Key words: Delayed gastric emptying, Gastric electrical stimulation, Gastric emptying scintigraphy, Gastric-per-oral endoscopic myotomy, Gastroparesis.