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

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.
Competing Interests: 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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