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March 12, 2026JGH Open2 citationsOpen Access

Progress in Gastroparesis Management: From Pharmacotherapy to Interventional Treatments

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GKGanesh KumarYSYash ShahURUme Rooman

Key Points

  • To evaluate current strategies in managing gastroparesis, focusing on pharmacological and interventional treatments.
  • Reviewed existing literature on pharmacotherapy and interventional treatments for gastroparesis.
  • Analyzed efficacy of treatments including prokinetics, antiemetics, and neuromodulation.
  • Discussed limitations and the need for multicenter trials to explore innovative therapies.
  • Metoclopramide is the only FDA-approved medication, but alternative treatments are being considered.
  • Non-pharmacological approaches like G-POEM show significant symptom improvements.
  • Overall understanding of best practices in gastroparesis treatment remains limited.

Abstract

ABSTRACT Gastroparesis is a sensorimotor condition characterized by delayed gastric emptying without any obvious mechanical obstruction. Common symptoms include early satiety, nausea, vomiting, belching, and bloating. The most frequent causes of gastroparesis are diabetes, idiopathic factors, and post‐surgical complications. Currently, the only FDA‐approved medication for treating gastroparesis is metoclopramide; however, due to its potential side effects, particularly extrapyramidal symptoms, there is increasing interest in safer, more tolerable alternatives, such as prokinetics, antiemetics, and fundic relaxants. Recent advancements in pharmacological agents have demonstrated variable efficacy in improving gastric emptying and gastroparesis‐related symptoms, although symptom improvement does not consistently correlate with changes in gastric emptying metrics. In addition to pharmacological treatments, non‐pharmacological approaches like gastric peroral endoscopic myotomy (G‐POEM) and neuromodulation techniques have demonstrated significant improvements in symptoms and gastric emptying. The current understanding of gastroparesis care is still limited, and the best practices in treatment remain uncertain. Future research should prioritize multicenter trials that involve large patient populations to explore emerging therapies and innovative techniques. In this review, we will discuss the existing standards of care, advancements in novel pharmacological, interventional, and neuromodulatory treatments for gastroparesis, as well as their clinical integration, limitations, and prospects.

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Cite This Study

Kumar et al. (2026) studied this question.

synapsesocial.com/papers/69b2577096eeacc4fcec60d6https://doi.org/10.1002/jgh3.70377
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