Gastroparesis: Concepts, Controversies, and Challenges

Box 6

         Targeting Gastric Dysmotility

Current Knowledge

Prokinetics are commonly used as the primary treatment of gastroparesis.

The available prokinetics effectively accelerate gastric emptying but have limited

impact on symptoms.

Tachyphylaxis may contribute to the limited efficacy of prokinetics.

Emerging Trends

Improving gastric accommodation or relaxation of the pyloric sphincter have

been targeted as alternative strategies, but have not yet been sufficiently tested

or are not superior to placebo (botulinum toxin).

Future Perspective

Ghrelin agonists are showing promise in initial short-time trials of patients with

gastroparesis, accelerating emptying, and improving symptoms.