The effect of chronic oral domperidone therapy on gastrointestinal symptoms, gastric emptying, and quality of life in patients with gastroparesis.

OBJECTIVE: Our aim was to determine whether domperidone could improve the symptoms of patients with gastroparesis, accelerate gastric emptying, and enhance quality of life.
METHODS: Seventeen patients (13 women, 4 men; mean age 42.9 yr) with documented gastroparesis were evaluated. A baseline gastric emptying study was performed using an isotope-labeled solid meal and a follow-up study was repeated > or =6 months after initiating domperidone therapy. The severity of nausea, vomiting, abdominal pain, and bloating were obtained at baseline and at 6-month intervals and were graded from 0 to 5 (0 = none, 5 = most severe). Also, the number of hospital admissions were noted during the study period. Patients were asked to assess their overall health status and quality of life and were begun on domperidone 20 mg q.i.d. On average, patients received domperidone for 23.3 months (range 6-48 months). Domperidone doses ranged from 40 to 120 mg daily during the study period.
RESULTS: Gastroparesis symptom scores were reduced from 4.1 +/- 0.22 (mean +/- SEM) to 1.3 +/- 0.2, and hospital admissions were decreased significantly during the study compared with before domperidone therapy (p < 0.05). At baseline, patients had a 87.3 +/- 3.71% retention of a solid meal at 2 hours compared with a 57.2 +/- 5.04% retention during domperidone therapy (p < 0.05). Domperidone treatment enhanced the quality of life in 88% of patients. The mean prolactin level was 58.9 pg/ml during the study and three patients reported gynecomastia.
CONCLUSIONS: Chronic domperidone treatment in patients with gastroparesis significantly reduced GI symptoms and hospitalizations, enhanced quality of life, and accelerated gastric emptying of a solid meal to a normal rate. Domperidone successfully treats gastroparesis on a long-term outcome basis and has an excellent safety profile.