What is Gastroparesis?

Gastroparesis is a condition where the stomach muscles don't work properly, slowing down or stopping the movement of food. It can be caused by:

• Diabetes

• Post-surgical nerve damage

• Medications

• Unknown reasons (idiopathic)

Common symptoms include:

• Nausea and vomiting

• Feeling full quickly when eating

• Bloating or upper abdominal discomfort

• Poor appetite and weight loss

Endoscopic therapies

• Endoscopic balloon dilation of the pylorus: occasionally used in selected cases.

• Botulinum toxin injection into the pylorus: temporary benefit for some patients; evidence is mixed and effects are often short-lived.

• Gastric peroral endoscopic pyloromyotomy (G-POEM): endoscopic cutting of the pyloric muscle to improve emptying; considered for refractory gastroparesis, with growing evidence of benefit in selected patients.

Why is G-POEM recommended?

G-POEM is recommended when:

• Medications and dietary changes haven’t worked

• You have moderate to severe symptoms affecting quality of life

• Tests (such as gastric emptying studies) confirm delayed stomach emptying

It’s a less invasive option than traditional surgery and can provide long-term symptom relief.

How is the procedure performed?

• The procedure is done under general anaesthesia.

• A flexible tube (gastroscope) is passed through your mouth into the stomach.

• A tunnel is made under the stomach lining to reach the pyloric muscle.

• The muscle is cut (myotomy) to allow food to pass more easily.

• The tunnel is closed with small clips, which fall off on their own.

There are no external cuts or scars.

What are the benefits?

• Minimally invasive

• Improves stomach emptying

• Reduces symptoms like nausea, vomiting, and bloating

• Shorter recovery compared to traditional surgery

• May reduce the need for long-term medications or feeding tubes

What are the risks?

While G-POEM is generally safe, possible risks include:

Bleeding: Usually minor and controlled during the procedure

Perforation: Rare, may require additional treatment or surgery

Infection: Antibiotics are given to reduce this risk

Reflux or indigestion: May occur after the procedure

No symptom improvement: In some cases, symptoms may persist or return

What happens after the procedure?

• Most patients stay in hospital for 1 day.

• You’ll start on clear fluids, then move to a soft diet, and eventually return to normal food over 1–2 weeks.

• You’ll be monitored for complications and to ensure your stomach is emptying better.

Long-term care and follow-up

• You’ll have regular follow-up with your doctor.

• Some patients may need repeat testing or further treatment.

• You may still need dietary advice or medications depending on your symptoms.

Frequently Asked Questions

Q: Will G-POEM cure gastroparesis?
A: It does not cure the underlying condition but can greatly improve symptoms in many patients.

Q: Is the procedure painful?
A: No, it is done under general anesthesia. Mild bloating or discomfort may be felt afterwards.

Q: How successful is G-POEM?
A: Studies show up to 60% symptom improvement.

Q: Can I eat normally afterward?
A: You’ll follow a special diet for a few weeks, gradually returning to normal eating.

Surgical interventions

• Pyloroplasty or pyloromyotomy (open or laparoscopic): surgical widening or cutting of the pylorus to facilitate gastric emptying; considered when other treatments fail.

• Gastric electrical stimulation (implantable gastric pacemaker): may reduce nausea and vomiting in refractory cases, particularly diabetic gastroparesis; benefit for emptying is variable.

• Feeding jejunostomy or gastrostomy with jejunal extension for long-term enteral nutrition when oral intake is insufficient.

Enterra Therapy