What Is the Treatment of Gastroparesis? First-Line Supportive Management
Gastroparesis presents with delayed gastric emptying and often requires a structured, stepwise approach beginning with non-pharmacologic and supportive measures before escalating to further intervention.
Treatment Approach
Initial management focuses on specific dietary modifications — tailored to reduce the burden of gastric emptying — alongside other structured supportive steps that address contributing factors and symptom control. The full sequenced regimen is available in the protocol below.
References
DOI: 10.1053/j.gastro.2025.08.004
- The Guideline Panel Content Experts use dietary interventions with small-particle and low-fat, low-residue diets before initiation of pharmacologic interventions or as a concomitant intervention.
- It is important to optimize glycemic control in individuals with gastroparesis in the setting of diabetes mellitus.
- It is important to review the patient's current medications to eliminate medications that may alter GI tract motility; medications that can delay gastric emptying include opiate pain medications and the glucagon-like peptide-1 receptor agonists for diabetes management and weight loss.
- Patients with gastroparesis may need to use antiemetics as needed, including selective serotonin receptor (5HT3) antagonists (eg, ondansetron and granisteron), histamine H1 antagonists (eg, promethazine), and/or dopamine D2 antagonists (eg, prochlorperazine).
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