UC expert weighs in on new clinical practice guideline for gastroparesis

Gastroparesis should be confirmed with a four-hour gastric emptying test before initiating first-line therapy, according to the first evidence-based, gastroparesis-focused clinical practice guideline issued by the American Gastroenterological Association (AGA). MedCentral recently reported on the new guideline. By addressing diagnostic inconsistencies and limited therapeutic options, the AGA developed this new guideline to standardize management of gastroparesis.

“Some of the significant new guideline recommendations include diagnostic testing, the importance of implementing a gastroparesis-specific diet alongside pharmacologic therapy, and, lastly, when to offer patients G-POEM,” Susan S. Kais, MD, told MedCentral. Kais is an assistant professor of clinical medicine in the Division of Digestive Diseases in the Department of Internal Medicine at University of Cincinnati College of Medicine.

Gastroparesis is a gastric motility disorder marked by delayed gastric emptying without evidence of obstruction, leading to symptoms such as nausea, vomiting and gastrointestinal discomfort. 

“Citing strong evidence that shorter protocols frequently miss delayed gastric emptying, this shift from the commonly used two-hour testing requires us to be more specific when ordering diagnostic testing to ensure that the radiology team now performs the four-hour protocol,” noted Kais, who is also a UC Health gastroenterologist.

Before the release of this new guideline, U.S. clinicians typically relied on the American College of Gastroenterology (ACG) guideline published in 2022. This new AGA guideline builds upon the foundation laid by the ACG, introducing more rigorous diagnostic standards, more conservative procedural recommendations and a more cautious approach to off-label therapies.

In addition, the guideline recommends a multidisciplinary approach, including dietetics, primary care and gastroenterology, with surgery or interventional endoscopy in select cases.

Read the full MedCentral article.

Featured image at top: iStock/Tharakorn.