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Management of Symptoms of Gastroparesis: An Expert Perspective

  • Authors: Henry P. Parkman, MD
  • CME / ABIM MOC Released: 2/22/2023
  • Valid for credit through: 2/22/2024
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  • Credits Available

    Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 0.25 ABIM MOC points

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for gastroenterologists, primary care physicians, diabetologists/endocrinologists, and other healthcare professionals who treat patients with gastroparesis.

The goal of this activity is for learners to better assimilate data for evidence-based treatments of gastroparesis in practice.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Clinical data on antiemetic agents for the management of gastroparesis symptoms
    • Role of drug delivery in the efficacy of agents used to treat gastroparesis symptoms


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All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


  • Henry P. Parkman, MD

    Stanley H. Lorber Research Endowment Fund and Chair, Gastroenterology, Lewis Katz School of Medicine at Temple University
    Vice Chair of Research, Department of Medicine, Lewis Katz School of Medicine at Temple University
    Professor, Medicine, Lewis Katz School of Medicine at Temple University
    Director, GI Motility Laboratory, Temple University Hospital
    Philadelphia, Pennsylvania, United States


    Henry P. Parkman, MD, has no relevant financial relationships.


  • Roderick Smith, MS

    Senior Medical Education Director, Medscape, LLC


    Roderick Smith, MS, has no relevant financial relationships.

  • Gina Montanero, PharmD

    Associate Medical Writer, Medscape, LLC


    Gina Montanero, PharmD, has no relevant financial relationships.

Compliance Reviewer

  • Esther Nyarko, PharmD

    Director, Accreditation and Compliance, Medscape, LLC


    Esther Nyarko, PharmD, has no relevant financial relationships.

Accreditation Statements

In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.25 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.


Management of Symptoms of Gastroparesis: An Expert Perspective

Authors: Henry P. Parkman, MDFaculty and Disclosures

CME / ABIM MOC Released: 2/22/2023

Valid for credit through: 2/22/2024



  1.  Simmons K, et al. Granisetron transdermal system improves refractory nausea and vomiting in gastroparesis. Dig Dis Sci. 2014;59:1231-1234.
  2. Grover M, et al. Gastroparesis: a turning point in understanding and treatment. Gut. 2019;68:2238-2250.
  3. Kumar A, et al. Visceral hypersensitivity and impaired accommodation in refractory diabetic gastroparesis. Neurogastroenterol Motil. 2008;20:635-642.
  4. Parkman HP, et al; NIDDK Gastroparesis Clinical Research Consortium (GpCRC). Early satiety and postprandial fullness in gastroparesis correlate with gastroparesis severity, gastric emptying, and water load testing. Neurogastroenterol Motil. 2017;29:10.1111/nmo.12981.
  5. Parkman HP, et al; NIDDK/NIH Clinical Gastroparesis Consortium. Factors that contribute to the impairment of quality of life in gastroparesis. Neurogastroenterol Motil. 2021;33:e14087.
  6. Yu D, et al. The burdens, concerns, and quality of life of patients with gastroparesis. Dig Dis Sci. 2017;62:879-893.
  7. Pasricha PJ, et al; NIDDK/NIH GpCRC consortium. Progress in gastroparesis -- a narrative review of the work of the Gastroparesis Clinical Research Consortium. Clin Gastroenterol Hepatol. 2022;20:2684-2695.e3.
  8. Camilleri M, et al. ACG clinical guideline: gastroparesis. Am J Gastroenterology. 2022;117:1197-1220.
  9. Midani D, et al. Granisetron transdermal system for treatment of symptoms of gastroparesis: a prescription registry study. J Neurogastroenterol Motil. 2016;22:650-655.
  10. Camilleri M, et al; American College of Gastroenterology. Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013;108:18-37; quiz 38.
  11. Rao AS, et al. Review article: metoclopramide and tardive dyskinesia. Aliment Pharmacol Ther. 2010;31:11-19.
  12. FDA. Domperidone IND packet for sponsors treating patients with gastrointestinal motility disorders. Updated September 27, 2021. Accessed January 30, 2023.,
  13. Parkman HP, et al, eds. Gastroparesis: Pathophysiology, Presentation and Treatment. Humana Press; 2012.
  14. Martinek J, et al. Endoscopic pyloromyotomy for the treatment of severe and refractory gastroparesis: a pilot, randomised, sham-controlled trial. Gut. 2022;71:2170-2178.
  15. Myint AS, et al. Current and emerging therapeutic options for gastroparesis. Gastroenterol Hepatol (N Y). 2018;14:639-645.
  16. Metoclopramide nasal spray [prescribing information]. Approved 1979. Revised June 2020.
  17. Parkman HP, et al. Metoclopramide nasal spray is effective in symptoms of gastroparesis in diabetics compared to conventional oral tablet. Neurogastroenterol Motil. 2014;26:521-528.
  18. Parkman HP, et al. Metoclopramide nasal spray reduces symptoms of gastroparesis in women, but not men, with diabetes: results of a phase 2B randomized study. Clin Gastroenterol Hepatol. 2015;13:1256-1263.e1.
  19. Granisetron transdermal system [prescribing information]. Approved 2008. Revised September 2015.
  20. Howell J, et al. Pharmacokinetics of a granisetron transdermal system for the treatment of chemotherapy-induced nausea and vomiting. J Oncol Pharm Pract. 2009;15:223-231.
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