Management of the patient with gastroparesis

Gastroparesis may be related to a variety of underlying disorders, but mana gement options are fairly universal. Dietary measures and pharmacologic age nts, primarily in the form of prokinetic medications, form the foundation o f standard management. Some patients will have refractory symptoms and alte rnative dosing schemes or drug combinations may be used. An occasional pati ent will still require venting gastrostomy and/or jejunal feeding. This rev iew addresses the standard dietary and pharmacologic approaches to gastropa resis, as well as issues pertaining to astrostomy/jejunostomy tubes and to surgical options for refractory cases. Finally, experimental agents and tec hniques, such as gastric pacing, will be discussed.