Management of Gastroparesis

First-Line Management

The American Gastroenterological Association recommends eating frequent smaller-size meals and replacing solid food with liquids, such as soups, for patients with gastroparesis 1
Foods should be low in fat and fiber content for patients with gastroparesis 1
A small particle size diet may improve key symptoms in patients with gastroparesis, according to the American Diabetes Association 4, 5
Liquid supplementation may be necessary for adequate nutrition in patients with gastroparesis 1

Metoclopramide is FDA-approved for diabetic gastroparesis and can be administered orally or intravenously, with a recommended dosage of 10 mg three times daily before meals, according to the American College of Gastroenterology 1, 6
Metoclopramide should be used cautiously due to the risk of serious adverse effects, such as extrapyramidal symptoms and tardive dyskinesia, and the FDA recommends limiting use to 12 weeks 5
Erythromycin is effective for short-term use but limited by tachyphylaxis, according to the American Gastroenterological Association 1, 5

Withdrawing medications that may worsen gastroparesis, such as opioids and anticholinergics, is recommended for patients with refractory gastroparesis, according to the American Diabetes Association 5
Enteral nutrition via jejunostomy tube should be considered for patients with persistent vomiting or weight loss, according to the American Gastroenterological Association 1

Careful regulation of glycemic control is essential for patients with diabetic gastroparesis, as hyperglycemia can worsen gastric emptying, according to the American Diabetes Association 5
A multidisciplinary approach involving gastroenterologists, dietitians, and surgeons may be necessary for patients with severe symptoms, according to the American College of Gastroenterology 6