Gastric Peroral Endoscopic Myotomy in Refractory Gastroparesis: A Narrative Review.
5 affiliations
- 1Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA.
- 2Department of Internal Medicine, Indiana University School of Medicine, Evansville, IN, USA.
- 3Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
- 4Department of Internal Medicine, University of Toledo Medical Center, Toledo, Ohio, USA.
- 5Division of Gastroenterology and Hepatology, School of Medicine, The University of Jordan, Amman, Jordan.
Abstract
Gastroparesis is a chronic and frequently incapacitating disorder marked by delayed gastric emptying in the absence of mechanical obstruction, leading to symptoms such as nausea, vomiting, early satiety, and abdominal pain. Traditional medical treatments are often insufficient, resulting in considerable morbidity and healthcare strain. Gastric peroral endoscopic myotomy (G-POEM) has developed in the last decade as a minimally invasive endoscopic technique aimed at addressing pyloric dysfunction. This review consolidates existing evidence on the efficacy, safety, predictors of response, and developing frameworks for outcome classification following G-POEM. Data from prospective single-center cohorts indicate clinical success rates up to 48% at 12 months, along with enhancements in symptom scores, gastric emptying, and quality of life in suitably selected patients. G-POEM has a favorable safety profile, with adverse events occurring in approximately 4%-6% of cases, the majority of which are manageable endoscopically. Notable recent advances include an international classification scheme that categorizes G-POEM outcomes into four response phenotypes according to the concordance between symptomatic and physiologic (gastric emptying) improvement, together with multicenter evidence supporting the safety of same-day discharge in uncomplicated cases. Although promising, existing evidence is constrained by variability in patient selection and outcome definitions, and there is a deficiency of randomized controlled trials. G-POEM constitutes a significant enhancement to the therapeutic options for refractory gastroparesis, with continuous improvements in patient stratification and post-procedural management anticipated to maximize results.
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BibTeX
@article{hadaki2026gastric,
title = {{Gastric Peroral Endoscopic Myotomy in Refractory Gastroparesis: A Narrative Review.}},
author = {Nwal Hadaki and Azizullah Beran and Karla Geisse and Amr Kais and Bisher Sawaf and Yusuf Hallak and Nikhitha Lavu and Mohammad Al-Haddad},
journal = {Saudi journal of medicine \& medical sciences},
year = {2026},
month = oct,
doi = {10.4103/sjmms.sjmms_129_26},
url = {https://europepmc.org/article/MED/42974567},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Gastric Peroral Endoscopic Myotomy in Refractory Gastroparesis: A Narrative Review.
AU - Nwal Hadaki
AU - Azizullah Beran
AU - Karla Geisse
AU - Amr Kais
AU - Bisher Sawaf
AU - Yusuf Hallak
AU - Nikhitha Lavu
AU - Mohammad Al-Haddad
PY - 2026
DA - 2026/10/14
JO - Saudi journal of medicine & medical sciences
DO - 10.4103/sjmms.sjmms_129_26
UR - https://europepmc.org/article/MED/42974567
AB - Gastroparesis is a chronic and frequently incapacitating disorder marked by delayed gastric emptying in the absence of mechanical obstruction, leading to symptoms such as nausea, vomiting, early satiety, and abdominal pain. Traditional medical treatments are often insufficient, resulting in considerable morbidity and healthcare strain. Gastric peroral endoscopic myotomy (G-POEM) has developed in the last decade as a minimally invasive endoscopic technique aimed at addressing pyloric dysfunction. This review consolidates existing evidence on the efficacy, safety, predictors of response, and developing frameworks for outcome classification following G-POEM. Data from prospective single-center cohorts indicate clinical success rates up to 48% at 12 months, along with enhancements in symptom scores, gastric emptying, and quality of life in suitably selected patients. G-POEM has a favorable safety profile, with adverse events occurring in approximately 4%-6% of cases, the majority of which are manageable endoscopically. Notable recent advances include an international classification scheme that categorizes G-POEM outcomes into four response phenotypes according to the concordance between symptomatic and physiologic (gastric emptying) improvement, together with multicenter evidence supporting the safety of same-day discharge in uncomplicated cases. Although promising, existing evidence is constrained by variability in patient selection and outcome definitions, and there is a deficiency of randomized controlled trials. G-POEM constitutes a significant enhancement to the therapeutic options for refractory gastroparesis, with continuous improvements in patient stratification and post-procedural management anticipated to maximize results.
SN - 1658-631X
SN - 2321-4856
ER -