This handout is for gastroparesis. Your care team identified this based on: chronic nausea, vomiting, early satiety, post-prandial fullness (≥3 months) (acg 2022).
Other reasons your team may use this plan: unexplained chronic vomiting + diabetes (acg 2022); 4-hour gastric emptying scintigraphy with >10% retention at 4h (acg 2022 gold standard); post-surgical (fundoplication, gastric/bariatric) or post-viral gp (acg 2022).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| dietary_modification | Small frequent (5-6/day) low-fat low-fiber meals; soft / liquid-blended consistency during flares; chew thoroughly | PO | meals | ACG 2022 — dietary modification is first-line for all GP patients |
| optimize_glycemic_control | A1c <7-8% per ADA + GP context; avoid hyperglycemia >180 (acutely worsens emptying) | PO/SC | continuous | ACG 2022 — hyperglycemia acutely worsens gastric emptying; tight control improves symptoms |
| discontinue_offending_meds | Discontinue or substitute opioids, GLP-1 agonists (semaglutide / tirzepatide), anticholinergics, TCAs where possible | PO/SC | one_time | ACG 2022 — drug-induced GP common and reversible |
| hydration_electrolyte_replacement | PO if tolerated; IV if severe | PO/IV | continuous | ACG 2022 — common in moderate-severe GP |
Plan: Gastroparesis tiered management — diet + glycemic + prokinetic + antiemetic + endoscopic / surgical (ACG 2022)
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
q1-3 mo while titrating; q6 mo stable; nutrition + diabetes coordination; psychiatric / quality-of-life support; discontinue metoclopramide by 12 weeks or when tardive dyskinesia signs (ACG 2022)
Guideline: ACG 2022 Clinical Guideline: Gastroparesis (Camilleri M et al, Am J Gastroenterol 2022)