Abstract
Gastroparesis as currently defined relies on symptoms with documented slow gastric emptying. Prokinetic agents are attractive in treating gastroparesis as they target the underlying pathophysiology that defines this disorder. Ideally, with prokinetic agents one would see improvement in gastric emptying with improvement in symptoms of gastroparesis. However, symptom response to treatment with prokinetic agents may not parallel changes in gastric emptying: symptoms may not change despite an improvement in gastric emptying and symptoms might improve without an improvement in gastric emptying. In addition, prokinetic agents often have side effects that limit their use. Only several prokinetic agents are currently available. Newer agents, including ghrelin, motilin, and 5-HT4 receptor agonists, as well as dopamine receptor antagonists are being investigated that, at least in initial studies, demonstrate efficacy and few side effects. This chapter will review the data regarding prokinetic therapy for patients with gastroparesis.
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