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Medical Management of Gastroparesis

  • Klaus Bielefeldt
  • Patrick McKenzie
  • John C. FangEmail author
Chapter

Abstract

Gastroparesis is a chronic neuromuscular disorder that can be disabling with significant impact on patient’s quality of life. Medical management is the cornerstone of treating patients with gastroparesis. The goals should focus on symptom control, maintenance of adequate weight, and prevention of nutritional deficiencies. Gastroparesis is part of a spectrum of functional diseases, which include functional dyspepsia, chronic unexplained nausea and vomiting, and cyclic vomiting syndrome. The delay in gastric emptying as a physiologic metric separates gastroparesis from these other functional illnesses. While gastric emptying as the disease-defining metric has been the traditional treatment target, the correlation between emptying delay and symptom severity is poor. Pharmacotherapy is thus shifting from an emphasis on prokinetics and changes in gastric emptying to agents that improve overall symptoms and quality of life independent of the underlying mechanism. There is only one FDA-approved medication for treatment of gastroparesis, and therefore most of the agents are used “off-label” for this condition. The components of medical management include nutritional and fluid management and pharmacotherapy with a combination of antiemetics, prokinetics, and neuromodulators. There is also renewed interest in non-pharmacologic treatments as well.

Keywords

Gastroparesis Medical therapy Gastric emptying Prokinetic Antiemetic 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Klaus Bielefeldt
    • 1
    • 2
  • Patrick McKenzie
    • 1
  • John C. Fang
    • 1
    Email author
  1. 1.Division of Gastroenterology and HepatologyUniversity of Utah School of MedicineSalt Lake CityUSA
  2. 2.Veterans Administration Medical CenterSalt Lake CityUSA

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