G-POEM for severe and refractory gastroparesis

Abstract

Gastroparesis is characterized by nausea, vomiting, abdominal pain and delayed gastric emptying. This chronic condition has few effective medical options. Gastric peroral endoscopic myotomy (G-POEM) is an emerging alternative to surgical pyloroplasty or pyloromyotomy that may provide relief in carefully selected patients with severe symptoms. This article summarizes the @GIJournal Twitter discussion of Martinek et al, “Endoscopic pyloromyotomy for the treatment of severe and refractory gastroparesis: a pilot, randomised, sham-controlled trial,” originally published in Gut. In this study of 40 patients, G-POEM was associated with significant improvement in symptoms and quality of life at 6 months, including patients who crossed over from sham, and especially in those with diabetic gastroparesis. Future studies will provide data on longer follow-up periods and examine strategies for G-POEM candidate selection.