Mirtazapine: a solution for postoperative gastroparesis?

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Obstructed para-oesophageal hiatus hernia can necessitate surgical intervention like gastropexy.
• Postoperative gastroparesis is a potential complication following such procedures.
• Conventional prokinetic agents (erythromycin, metoclopramide, ondansetron, domperidone) are often insufficient for severe cases.

Purpose of the Study:

• To report a case of refractory gastroparesis post-gastropexy.
• To evaluate the efficacy of mirtazapine in managing this condition.
• To review the literature on gastroparesis treatment.

Main Methods:

• Case presentation of a 52-year-old male with obstructed para-oesophageal hiatus hernia and subsequent gastropexy.
• Documentation of postoperative gastroparesis and inadequate response to standard prokinetic therapies.
• Administration of mirtazapine and assessment of symptom response.

Main Results:

• The patient developed gastroparesis after gastropexy.
• Conventional prokinetic drugs provided inadequate symptom relief.
• Mirtazapine administration led to rapid and significant symptom improvement.

Conclusions:

• Mirtazapine may be an effective treatment option for refractory gastroparesis.
• Further research is warranted to confirm the role of mirtazapine in gastroparesis management.
• This case underscores the need for exploring alternative therapeutic strategies for complex gastrointestinal motility disorders.