Gastroparesis: New insights into an old disease

Table 4 Therapeutic strategies

	Mild gastroparesis	Moderate gastroparesis	Severe gastroparesis
Diet and nutritional support	Adequate oral nutrition	Disturbed oral nutrition	Compromized oral nutrition
	Small frequent meals; Low fat, low fibre; Glycemic control in diabetics	Small, frequent meals; Low fat, low fibre; Glycemic control in diabetics; Caloric liquids; Artificial nutrition rarely required	Liquid nutrient supplements; Nutrition by PEG-J
Prokinetics	Metroclopramide; Domperidone; Levosulpiride	Metroclopramide; Domperidone; Levosulpiride	1Metroclopramide; Domperidone; 1Levosulpiride; 1Erytromycin; Prucalopride
Antiemetics and symptom modulators	Rarely needed	Ondansetron	1Ondansetron; Triciclic antidepressant; Cannabinoids
			Drug-refractory patients
Endoscopic techniques	Not needed	Not needed	Botulin toxin; Transpyloric stenting; Ballon dilatation; G-POEM
Gastric electrostimulation	Not needed	Not needed	Compassionate use
Gastric procedures	Not needed	Not needed	Laparoscopic Pyloroplastic

¹Available for intravenous administration. PEG-J: Percutaneous endoscopic transgastric jejunostomy; G-POEM: Gastric peroral endoscopic myotomy.