American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis
Abstract
This literature review and the recommendations herein were prepared for the American Gastroenterological Association Clinical Practice Committee. The paper was approved by the Committee on May 16, 2004, and by the AGA Governing Board on September 23, 2004.
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DGP is estimated to affect 5%-12% of individuals with long-term diabetes, in cohorts with systematic gastric emptying evaluation (symptom-based criteria plus objective testing).
“DGP is estimated to affect 5% − 12% of individuals with long-term diabetes, in cohorts with systematic gastric emptying evaluation (symptom-based criteria plus objective testing) [7, 8]”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [7]
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“Gastroparesis is diagnosed when symptoms such as nausea, vomiting, early satiety, postprandial fullness, abdominal discomfort, and pain are associated with objective evidence of delayed GE in the absence of obstruction, and typically with impairment in maintenance of normal nutrition using standardfood( 4 ,8).Thesesym…”
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Self-citationBotulinum Toxin A for the Treatment of Delayed Gastric Emptying
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BackgroundReview article: metoclopramide and tardive dyskinesia
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“Gastroparesis is defined as a syndrome characterised by abnormal gastric function resulting in delayed gastric emptying in the absence of mechanical obstruction.(2) What was first thought to be a rare complication that occurs only in type 1 diabetes is now known to occur in both type 1 and type 2 diabetes(3) and to oc…”
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“Although metoclopramide is approved for short-term (up to 1 month) management of diabetic gastroparesis, in practice this directive is seldom adhered to, given the chronic nature of this condition”
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Self-citationMetoclopramide in the treatment of diabetic gastroparesis
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Self-citationAbdominal Pain Is a Frequent Symptom of Gastroparesis
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“However, the treatment of gastroparesis remains a great challenge. Generally, for mild to moderate disease, diet modifications and antiemetic or prokinetic medications may be useful to control symptoms. However, patients with severe manifestations of gastroparesis may require more aggressive treatment such as intraven…”
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“Other disorders that result in similar symptoms, including peptic ulcer disease, gastroesophageal reflux disease, gastric cancer, pancreatic or biliary disease, and gastric outlet or mechanical small bowel obstruction,([1]) need to be excluded with appropriate investigations, such as endoscopy and contrast radiology s…”
InfluentialGastroparesis: Approach, Diagnostic Evaluation, and Management
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“Symptom ‘turnover’ occurs frequently [2].”
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Factors that affect gastric passage of video capsule
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Delivery of therapeutic carbon monoxide by gas-entrapping materials
Byrne, J. D., Gallo, D., Boyce, H., Becker, S. L., Kezar, K., Cotoia, A. T., Feig, V., Lopes, A., Csizmadia, E., Longhi, M., et al. (2022) · Science Translational Medicine · doi:10.1126/scitranslmed.abl4135 · Cited by 81
Murray, H. B., Jehangir, A., Silvernale, C. J., Kuo, B., & Parkman, H. P. (2020) · Neurogastroenterology & Motility · doi:10.1111/nmo.13931 · Cited by 90 · see citing works
“Patients completed the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS), which is a 9-item measure of avoidant/ restrictive eating symptoms with three questions for each of the underlying motivations for avoidant/restrictive eating: (1) sensory characteristics, (2) fear of aversive consequences, and (…”
MethodSelf-citationGastroparesis Updates on Pathogenesis and Management
Liu, N., & Abell, T. L. (2017) · Gut and Liver · doi:10.5009/gnl16336 · Cited by 89 · see citing works
Clinical Practice Guidelines for Functional Dyspepsia in Korea
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Morscher, S., Driessen, W., Claussen, J., & Burton, N. (2014) · Photoacoustics · doi:10.1016/j.pacs.2014.06.001 · Cited by 78 · see citing works
Wo, J. M., Ejskjær, N., Hellström, P. M., Malik, R. A., Pezzullo, J. C., Shaughnessy, L., Charlton, P. A., Kosutic, G., & McCallum, R. W. (2011) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2010.04567.x · Cited by 73 · see citing works
Xu, J.-X., Chen, T.-Y., Elkholy, S., Xu, M.-D., Zhong, Y.-S., Zhang, Y.-Q., Chen, W.-F., Qin, W., Cai, M., & Zhou, P. (2018) · Canadian Journal of Gastroenterology and Hepatology · doi:10.1155/2018/6409698 · Cited by 75 · see citing works
Parkman, H. P., Hallinan, E., Hasler, W. L., Farrugia, G., Koch, K. L., Calles, J., Snape, W. J., Abell, T. L., Sarosiek, I., McCallum, R. W., et al. (2016) · Neurogastroenterology & Motility · doi:10.1111/nmo.12893 · Cited by 79 · see citing works
Self-citationPathophysiology and pharmacotherapy of gastroparesis: current and future perspectives
Stevens, J. E., Jones, K. L., Rayner, C. K., & Horowitz, M. (2013) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2013.795948 · Cited by 87 · see citing works
“As is often the case in patients with intestinal motor disorders, the cause of symptoms may, as discussed, be multifactorial [1], with some symptoms probably relating to specific motor and/or sensory dysfunction [39].”
BackgroundInfluentialGhareghani, M., Reiter, R., Zibara, K., & Farhadi, N. (2018) · Frontiers in Immunology · doi:10.3389/fimmu.2018.02484 · Cited by 74 · see citing works
“Gut stasis is a potentially deadly condition in which the digestive system slows down or stops completely whereas gastroparesis is a chronic disorder of delayed gastric emptying characterized by food remaining in the stomach for a longer time than normal (79).”
BackgroundCassilly, D. W., Wang, Y. R., Friedenberg, F. K., Nelson, D. B., Maurer, A. H., & Parkman, H. P. (2008) · Digestion · doi:10.1159/000175836 · Cited by 75 · see citing works
“Gastroparesis is a chronic symptomatic disorder of the stomach characterized by delayed gastric emptying (DGE) in the absence of mechanical obstruction [”
BackgroundSelf-citationDesigning Food Structures for Nutrition and Health Benefits
Norton, J. E., Wallis, G. A., Spyropoulos, F., Lillford, P. J., & Norton, I. T. (2014) · Annual Review of Food Science and Technology · doi:10.1146/annurev-food-030713-092315 · Cited by 84 · see citing works
Different faces of gastroparesis
Bielefeldt, K., Raza, N., & Zickmund, S. L. (2009) · World Journal of Gastroenterology · doi:10.3748/wjg.15.6052 · Cited by 71 · see citing works
Barboza, J., Okun, M. S., & Moshiree, B. (2015) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2015.1086747 · Cited by 78 · see citing works
“2 Gastroparesis GP is a chronic GI condition involving the stomach and is defined as a delayed gastric emptying in the absence of mechanical obstruction [18].”
BackgroundSpectrum of Gastroparesis in Children
Waseem, S., Islam, S., Kahn, G., Moshiree, B., & Talley, N. J. (2012) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e31824cf06e · Cited by 78 · see citing works
Lu, K. ‐., Cao, J., Oleson, S., Ward, M. P., Phillips, R. J., Powley, T. L., & Liu, Z. (2018) · Neurogastroenterology & Motility · doi:10.1111/nmo.13380 · Cited by 74 · see citing works
“Dysregulation of gastrointestinal (GI) function is associated with gastroparesis (1, 2), obesity (3) gastroesophageal reflux disease and other GI disorders (4).”
BackgroundDiagnostic Utility of Wireless Motility Capsule in Gastrointestinal Dysmotility
Rao, S. S. C., Mysore, K., Attaluri, A., & Valestin, J. (2011) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e3181ff0122 · Cited by 70 · see citing works
“An abnormal scintigraphic GET was defined as greater than 10% retention at 4 hours (delayed gastric emptying) or less than 20% retention at 1 hour (rapid gastric emptying).(18,26) Retention of 6 or more radiopaque markers at 120 hours was defined as abnormal colonic transit.”
MethodPromotility Medications – Now and in the Future
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“In adults, 2 hour studies have been used commonly for detecting gastroparesis, although 4 hour studies are now being advocated as the Bgold standard[ (23).”
MethodMeybodi, M. A., Qumseya, B., Shakoor, D., Lobner, K. L., Vosoughi, K., Ichkhanian, Y., & Khashab, M. (2019) · Endoscopy International Open · doi:10.1055/a-0812-1458 · Cited by 69 · see citing works
“Patients with gastroparesis respond poorly to prokinetic, analgesic and antiemetic agents and they frequently present with refractory symptoms [1, 4, 6].”
BackgroundSarosiek, I., Förster, J., Lin, Z., Cherry, S., Sarosiek, J., & McCallum, R. W. (2012) · Neurogastroenterology & Motility · doi:10.1111/nmo.12032 · Cited by 73 · see citing works
Treier, R., Steingoetter, A., Weishaupt, D., Goetze, O., Boesiger, P., Fried, M., & Schwizer, W. (2006) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.20507 · Cited by 70 · see citing works
“However, the difference in emptying dynamics and meal volume after 90 minutes was subtle and small compared to the changes observed for meal emptying in patients diagnosed with gastroparesis (15).”
ResultA link between gastrointestinal disorders and migraine: Insights into the gut–brain connection
Aurora, S. K., Shrewsbury, S. B., Ray, S., Hindiyeh, N. A., & Nguyen, L. A. B. (2021) · Headache The Journal of Head and Face Pain · doi:10.1111/head.14099 · Cited by 83 · see citing works
Gastroesophageal reflux and lung transplantation.
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Raviv, Y., D'Ovidio, F., Pierre, A., Chaparro, C., Freeman, M., Keshavjee, S., & Singer, L. (2012) · Clinical Transplantation · doi:10.1111/j.1399-0012.2011.01434.x · Cited by 68
- Authors
- Parkman, H. P., Hasler, W. L., & Fisher, R. S.
- Affiliations
- Temple University (US)
- University of Michigan (US)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2004-11
- Volume
- 127
- Issue
- 5
- Pages
- 1592-1622
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W1968058596
- Cited by
- 738
- References
- 295
- Citations by year
- 2026: 19 · 2025: 31 · 2024: 28 · 2023: 28 · 2022: 29 · 2021: 40 · 2020: 52 · 2019: 54 · 2018: 44 · 2017: 26 · 2016: 28 · 2015: 35 · 2014: 31 · 2013: 40 · 2012: 34
- FWCI
- 4.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Keywords
- gastroparesis, diagnosis, treatment, clinical guidelines, delayed gastric emptying
- MeSH terms
- Breath Tests, Diagnosis, Differential, Gastric Emptying, Gastrointestinal Motility, Humans, Gastroparesis
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