Tumor-associated gastroparesis: correction with metoclopramide

Little is known about gastric emptying or its importance in the feeding disorders of cancer patients. In 70 percent of patients with upper gastrointestinal tumors who complained of satiety and postprandial fullness, gastric emptying was prolonged, as measured by a radioisotopic method. Metoclopramide was studied prospectively in 10 patients with unresectable upper gastrointestinal neoplasia and tumor-related gastroparesis. All patients had measurable subjective improvement with the therapy. There was a high correlation between objective improvement in gastric emptying and higher symptom scores after therapy. Results of baseline gastric emptying studies were predictive of therapeutic response. Requirements for hospitalization and antinauseants were reduced in all patients. Patients in whom response was positive gained weight and were able to take advantage of specific tumor therapies in an outpatient setting. Metoclopramide is a useful adjunct to the palliative regimen extended to patients with upper gastrointestinal tumors.