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Safety of treatment for gastroparesis

ABSTRACT Introduction: Gastroparesis is a syndrome of chronic, often debilitating symptoms related to impaired gastric motility, resulting in delayed emptying of the stomach, within the setting of a documented absence of any mechanical obstruction in the upper gastrointestinal tract. This disorder manifests with the presence of early satiety, postprandial fullness, nausea, vomiting, bloating and abdominal pain. The past ten years have shown significant advances in knowledge of the pathophysiology of this entity as well as in new diagnostic tests. However, in the clinical world which requires treatment of gastroparetic symptoms, the pharmacological options have been limited and sometimes less than optimal. Areas covered: This article provides an overview of the safety of the available pharmacological therapies utilized in the treatment of gastroparetic symptoms specifically addressing the safety of prokinetics, antiemetics, sensory neuromodulators and pain modifying agents. In addition, a brief overview of the evolving but yet to be officially approved agents is included. Expert opinion: None of the medications used for the treatment of gastroparesis are devoid of side effects. Therefore, when prescribing these medications, the risk/benefit ratio should be considered. Since those agents are increasingly administered in combination, awareness of possible drug interactions must be considered in a setting of the patients’ medical history, age, systemic diseases and other medications.