THE EFFECT OF CHRONIC ORAL DOMPERIDONE THERAPY ON GASTROINTESTINAL SYMPTOMS, GASTRIC-EMPTYING, AND QUALITY-OF-LIFE IN PATIENTS WITH GASTROPARESIS

Objective: Our aim was to determine whether domperidone could improve the symptoms of patients with gastroparesis, accelerate gastric emptyi ng, and enhance quality of life. Methods: Seventeen patients (13 women , 4 men; mean age 42.9 yr) with documented gastroparesis were evaluate d, A baseline gastric emptying study was performed using an isotope-la beled solid meal and a follow-up study was repeated greater than or eq ual to 6 months after initiating domperidone therapy, The severity of nausea, vomiting, abdominal pain, and bloating were obtained at baseli ne and at 6-month intervals and were graded from 0 to 5 (0 = none, 5 = most severe), Also, the number of hospital admissions were noted duri ng the study period, Patients were asked to assess their overall healt h status and quality of life and were begun on domperidone 20 mg q.i.d . On average, patients received domperidone for 23.3 months (range 6-4 8 months), Domperidone doses ranged from 40 to 120 mg daily during the study period, Results: Gastroparesis symptom scores were reduced from 4.1 +/- 0.22 (mean +/- SEM) to 1.3 +/- 0.2, and hospital admissions w ere decreased significantly during the study compared with before domp eridone therapy (p < 0.05), At baseline, patients had a 87.3 +/- 3.71% retention of a solid meal at 2 hours compared with a 57.2 +/- 5.04% r etention during domperidone therapy (p < 0.05), Domperidone treatment enhanced the quality of life in 88% of patients, The mean prolactin le vel was 58.9 pg/ml during the study and three patients reported gyneco mastia, Conclusions: Chronic domperidone treatment in patients with ga stroparesis significantly reduced GI symptoms and hospitalizations, en hanced quality of life, and accelerated gastric emptying of a solid me al to a normal rate, Domperidone successfully treats gastroparesis on a long-term outcome basis and has an excellent safety profile.