Recommendations Issued for Diagnosing, Managing Gastroparesis

MONDAY, Sept. 29, 2025 (HealthDay News) — In a clinical practice guideline issued by the American Gastroenterological Association and published in the October issue of Gastroenterology, conditional recommendations are presented for the diagnosis and management of gastroparesis.

Kyle Staller, M.D., M.P.H., from Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues assessed the evidence and developed recommendations for ensuring an accurate diagnosis and management of patients with idiopathic gastroparesis or gastroparesis related to diabetes.

Twelve recommendations were agreed upon by the guideline panel. For individuals with suspected gastroparesis, a conditional recommendation was made against using two-hour gastric emptying testing and in favor of four-hour testing. Conditional recommendations were made for use of metoclopramide and erythromycin in patients with gastroparesis and against the use of domperidone, prucalopride, aprepitant, nortriptyline, buspirone, and cannabidiol as first-line therapies. In addition, routine use of gastric per-oral endoscopic pyloromyotomy or gastric electrical stimulation is not recommended for patients with gastroparesis; these treatments should be used for select patients with symptoms refractory to medical therapies. There were no recommendations made for use of surgical pyloromyotomy and surgical pyloroplasty.

“These are not hard “yes” or “no” rules,” Staller said in a statement. “If a treatment is “suggested against,” it doesn”t mean never, since it could still be right for some patients. The goal is for patients and providers to weigh benefits, risks, and personal goals.”

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