What medical therapies work for gastroparesis?
Q: What medical therapies work for gastroparesis? Evidence-based answer: It’s unclear if there are any highly effective medications for gastroparesis (TABLE1-10). Metoclopramide improves the sense of fullness by about 40% for as long as 3 weeks, may improve nausea, and doesn’t affect vomiting or anorexia (strength of recommendation [SOR]: B, small randomized controlled trial [RCT]). Whether or not erythromycin has an effect on symptoms is unclear (SOR: C, conflicting trials and expert opinion). Domperidone may improve quality of life (by 2%) for as long as a year, but its effect on symptoms is also unclear (SOR: C, small RCTs). Cisapride may not be effective for symptom relief (SOR: C, small conflicting RCTs), and levosulpiride is likely similar to cisapride (SOR: C, single small crossover trial). Nortriptyline (SOR: B, single RCT) and intrapyloric botulinum toxin A (SOR: B, small RCT and crossover trial) aren’t effective for symptom relief.
JOURNAL OF FAMILY PRACTICE | NOVEMBER 2018 | VOL 67, NO 11: 720-722