Rome Foundation and international neurogastroenterology and motility societies' consensus on idiopathic gastroparesis

Jolien Schol¹, I-Hsuan Huang², Florencia Carbone³, Luis Maria Bustos Fernandez⁴, Guillaume Gourcerol⁵, Vincent Ho⁶, Geoffrey Kohn⁷, Brian E Lacy⁸, Aurelio Lopez Colombo⁹, Hiroto Miwa¹⁰, Baha Moshiree¹¹, Linda Nguyen¹², Greg O'Grady¹³, Kewin T H Siah¹⁴, Vincenzo Stanghellini¹⁵, Jan Tack¹⁶

Affiliations

¹ Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium; Division of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
² Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium; Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
³ Division of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
⁴ Centro Médico Bustos-Fernández, Buenos Aires, Argentina.
⁵ Department of Physiology, UMR INSERM 1073 & CIC INSERM 1404, Rouen University Hospital, Rouen, France.
⁶ School of Medicine, Western Sydney University, Sydney, NSW, Australia.
⁷ Department of Surgery, Monash University, Melbourne, VIC, Australia.
⁸ Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.
⁹ UMAE, Hospital de Especialidades, Centro Médico Nacional Manuel Avila Camacho, Puebla, Mexico.
¹⁰ Department of Internal Medicine, Kawanishi City Medical Center, Hyogo, Japan.
¹¹ Atrium Health, Division of Gastroenterology, Hepatology, and Nutrition, Wake Forest Medical University, Charlotte, NC, USA.
¹² Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, CA, USA.
¹³ Department of Surgery, University of Auckland, Auckland, New Zealand.
¹⁴ Division of Gastroenterology and Hepatology, University Medicine Cluster, National University Hospital, Singapore; Department of Internal Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
¹⁵ Division of Internal Medicine, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.
¹⁶ Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium; Division of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: jan.tack@kuleuven.be.

PMID: 39674226
DOI: 10.1016/S2468-1253(24)00284-X

Rome Foundation and international neurogastroenterology and motility societies' consensus on idiopathic gastroparesis

Jolien Schol et al. Lancet Gastroenterol Hepatol. 2025 Jan.

. 2025 Jan;10(1):68-81.

doi: 10.1016/S2468-1253(24)00284-X.

Authors

Affiliations

¹ Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium; Division of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
² Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium; Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
³ Division of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
⁴ Centro Médico Bustos-Fernández, Buenos Aires, Argentina.
⁵ Department of Physiology, UMR INSERM 1073 & CIC INSERM 1404, Rouen University Hospital, Rouen, France.
⁶ School of Medicine, Western Sydney University, Sydney, NSW, Australia.
⁷ Department of Surgery, Monash University, Melbourne, VIC, Australia.
⁸ Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.
⁹ UMAE, Hospital de Especialidades, Centro Médico Nacional Manuel Avila Camacho, Puebla, Mexico.
¹⁰ Department of Internal Medicine, Kawanishi City Medical Center, Hyogo, Japan.
¹¹ Atrium Health, Division of Gastroenterology, Hepatology, and Nutrition, Wake Forest Medical University, Charlotte, NC, USA.
¹² Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, CA, USA.
¹³ Department of Surgery, University of Auckland, Auckland, New Zealand.
¹⁴ Division of Gastroenterology and Hepatology, University Medicine Cluster, National University Hospital, Singapore; Department of Internal Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
¹⁵ Division of Internal Medicine, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.
¹⁶ Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium; Division of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: jan.tack@kuleuven.be.

PMID: 39674226
DOI: 10.1016/S2468-1253(24)00284-X

Abstract

To establish a consensus on the definition and management of idiopathic gastroparesis, international experts (selected by neurogastroenterology and motility societies and initiated by the Rome Foundation) devised 144 statements using the Delphi method, with at least 80% agreement required. This consensus defined idiopathic gastroparesis as the presence of symptoms associated with delayed gastric emptying in the absence of mechanical obstruction. Nausea and vomiting were identified as cardinal symptoms. Frequently co-existing symptoms are early satiation and postprandial fullness. Diagnosis requires the presence of these symptoms alongside delayed gastric emptying, measured by a 4 h scintigraphy or gastric emptying breath test of a mixed composition meal in the absence of mechanical obstruction. Therapeutic options with proven efficacy were sparse. Dietary adjustments, nutritional support (per guidelines from the European Society for Clinical Nutrition and Metabolism for substantial weight loss or intractable vomiting), and opioid cessation were recommended by a consensus opinion. Antiemetic and prokinetic agents were also considered potentially beneficial. This consensus offers a global perspective on idiopathic gastroparesis.

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Conflict of interest statement

Declaration of interests JT has given scientific advice to Aclipse, Adare, AlfaSigma, Bayer, Clasado, Danone, Falk, FitForMe, Ironwood, Kyowa Kirin, Menarini, Promed, Ricordati, Takeda, Truvion, Tsumura, and Zeria Pharmaceuticals; has received financial research support from Biohit, Kiowa Kirin, ProMed, Sofar, and Takeda; and has served on the speaker bureau for Abbott, Bio-Codex, Mayoly, Menarini, ProMed, Schwabe, Takeda, and Truvion Pharmaceuticals. BEL is on scientific advisory boards for Ironwood, Salix, Takeda, and Sanofi. VS is a consultant or speaker for AlfaSigma, Bayer, Coloplast, and Metagenics. HM has received speaking fees from Takeda, Viatris, EA Pharma, and Astra. GG has served as a consultant or speaker for Laborie, Medtronic, Kyowa Kirin, Lilly, and Enterra Medical. GO’G is a director and shareholder of Insides Company and Alimetry and holds patents and other intellectual property in the fields of gastrointestinal electrophysiology and neuromodulation (US11712566B2; US20230083795A1). BM has participated in the advisory board and received grant support from Atmo, and grant support from Takeda, Medtronic, and the Gastroparesis Consortium (NIDDK NIH UO1 grant). LN is a consultant for Enterra Medical, Ardelyx, Phathom, Evoke, and Takeda. All other authors have no competing interests.

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Rome Foundation and international neurogastroenterology and motility societies' consensus on idiopathic gastroparesis

Affiliations

Rome Foundation and international neurogastroenterology and motility societies' consensus on idiopathic gastroparesis

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical