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A new clinical practice guideline from the American Gastroenterological Association helps support physicians who are treating patients with gastroparesis. The condition is difficult to diagnose and treat, so the new guidelines outline the current state of the evidence for clinical options, as published in Gastroenterology. Part of the motivation for publishing the insight comes from possible new risks for gastroparesis related to glucagon-like peptide-1 (GLP-1) receptor agonists that are increasingly being used by patients for weight loss and diabetes, according to MedPage Today. Among the recommendations, guidance suggests clinicians might consider metoclopramide (limited to 12 weeks because of concerns for side effects) or erythromycin as first-line treatments and avoid use of domperidone, prucalopride, aprepitant, nortriptyline, or buspirone as first-line treatments. Guidance also recommends 4-hour gastric emptying studies to establish the diagnosis.
GLP-1 connection: A study in JAMA published in 2023 found the incidence of gastroparesis with semaglutide use was 9.1 per 1,000 person years, 7.3 with liraglutide, and 3.1 with bupropion-naltrexone. Learn more about weight loss drugs from the JUCM archive: Updates in Weight Management Pharmacotherapy: Essential Knowledge For The Urgent Care Clinician