The Impact of Gastroparesis on Medical Therapy for Gastroesophageal Reflux Disease

Abstract

Symptoms suspicious for gastroesophageal reflux disease (GERD) represent frequent indications for medical presentation, as do symptoms potentially compatible with delayed gastric emptying. In this clinical setting, care must be taken to characterize patient symptoms accurately, and also appropriately evaluate for pathophysiologic processes including visceral hypersensitivity, rumination syndrome, supragastric belching, cannabinoid hyperemesis, and cyclic vomiting syndrome. While proton pump inhibitors (PPI) are the foundation of medical management of GERD, delayed gastric emptying is a downstream factor that can promote gastroesophageal reflux and warrants tailored clinical management. Specifically, patients with refractory symptoms in the setting of GERD and delayed gastric emptying may benefit from personalized adjunct medical therapy with prokinetics.