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Gastroenterol Clin North Am. 2015 Mar;44(1):113-26. doi: 10.1016/j.gtc.2014.11.009. Epub 2014 Dec 26.

Symptomatic management for gastroparesis: antiemetics, analgesics, and symptom modulators.

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Division of Gastroenterology, University of Michigan Health System, 3912 Taubman Center, SPC 5362, Ann Arbor, MI 48109, USA. Electronic address:


Although prokinetic agents typically are used for gastroparesis, antiemetic, analgesic, and neuromodulatory medications may help manage nausea, vomiting, pain, or discomfort. Antiemetic benefits are supported by few case reports. An open series reported symptom reductions with transdermal granisetron in gastroparesis. Opiates are not advocated in gastroparesis because they worsen nausea and delay emptying. Neuromodulators have theoretical utility, but the tricyclic agent nortriptyline showed no benefits over placebo in an idiopathic gastroparesis study raising doubts about this strategy. Neurologic and cardiac toxicities of these medications are recognized. Additional controlled study is warranted to define antiemetic, analgesic, and neuromodulator usefulness in gastroparesis.


Antiemetic medications; Fundus relaxants; Neuropathic pain modulators; Opiates; Tricyclic antidepressants

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