Table 4.
Therapeutic strategies
Mild gastroparesis | Moderate gastroparesis | Severe gastroparesis | |
Diet and nutritional support | Adequate oral nutrition | Disturbed oral nutrition | Compromized oral nutrition |
Small frequent meals; Low fat, low fibre; Glycemic control in diabetics | Small, frequent meals; Low fat, low fibre; Glycemic control in diabetics; Caloric liquids; Artificial nutrition rarely required | Liquid nutrient supplements; Nutrition by PEG-J | |
Prokinetics | Metroclopramide; Domperidone; Levosulpiride | Metroclopramide; Domperidone; Levosulpiride | 1Metroclopramide; Domperidone; 1Levosulpiride; 1Erytromycin; Prucalopride |
Antiemetics and symptom modulators | Rarely needed | Ondansetron | 1Ondansetron; Triciclic antidepressant; Cannabinoids |
Drug-refractory patients | |||
Endoscopic techniques | Not needed | Not needed | Botulin toxin; Transpyloric stenting; Ballon dilatation; G-POEM |
Gastric electrostimulation | Not needed | Not needed | Compassionate use |
Gastric procedures | Not needed | Not needed | Laparoscopic Pyloroplastic |
Available for intravenous administration. PEG-J: Percutaneous endoscopic transgastric jejunostomy; G-POEM: Gastric peroral endoscopic myotomy.