title: Treatment of refractory gastroparesis: gastric and jejunal tubes, botox, gastric electrical stimulation, and surgery.
abstract: Refractory gastroparesis is a challenging disorder for gastroenterologists, internists, surgeons, and all health care professionals involved in the care of these patients. It should be managed by a stepwise algorithm beginning with dietary modifications, then prokinetic and antiemetic medications, measures to control pain and address psychological issues, and endoscopic or surgical options in selected patients, including placement of feeding jejunostomy tubes.
authors.affiliation: Department of Medicine, Center for GI Nerve & Muscle Function, Division of GI Motility, Kansas University Medical Center, 3901 Rainbow Boulevard, MS 1058, Kansas City, KS 66160, USA.
authors.forename: Reza A
authors.initials: RA
authors.lastname: Hejazi
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCallum
mesh_terms: D000465:Algorithms; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D000932:Antiemetics / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use*; D018492:Dopamine Antagonists / Q000627:therapeutic use; D004599:Electric Stimulation Therapy; D005743:Gastrectomy; D018589:Gastroparesis / Q000178:diet therapy / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007582:Jejunostomy; D018529:Nutritional Support / Q000295:instrumentation / Q000379:methods; D011964:Receptors, Gastrointestinal Hormone / Q000819:agonists; D018013:Receptors, Neuropeptide / Q000819:agonists; D012008:Recurrence; D013270:Stomach / Q000294:innervation; D016896:Treatment Outcome
chemical_list: D018726:Anti-Dyskinesia Agents; D000932:Antiemetics; D018492:Dopamine Antagonists; D011964:Receptors, Gastrointestinal Hormone; D018013:Receptors, Neuropeptide; C050802:motilin receptor; D001905:Botulinum Toxins