In patients diagnosed with gastroparesis, endoscopic pyloromyotomy was found to be better than sham procedure to improve symptoms and gastric emptying six months following the procedure.

A pilot sham-controlled trial aimed to compare the efficacy of the gastric peroral endoscopic myotomy (G-POEM) with a sham procedure to improve symptoms and gastric emptying in severe and refractory gastroparesis patients.

Overall, 41 people (11 idiopathic, 13 postsurgical, and 17 diabetic gastroparesis) were randomly divided into G-POEM (n = 21) and sham group (n=20). In this prospective randomized trial, the percentage of patients with treatment success at six months (reduction in Gastroparesis Cardinal Symptom Index [GCSI] by at least 50%) was the major outcome ascertained. People with persistent symptoms were randomized to the sham group and were offered cross-over endoscopic pyloromyotomy.

Notably, the treatment success rate came out to be 71% following endoscopic pyloromyotomy and  22% after sham procedure. Following G-POEM and sham procedure, the treatment success in people with idiopathic, postsurgical, and diabetic gastroparesis is depicted in Table 1.

After G-POEM, a reduction in median gastric retention at 4 hours was observed from 22% to 12%. No alteration in median gastric retention was observed after sham (26% versus 24%). Notably, 12 patients crossed over to G-POEM with nine of them (75%) attaining treatment success.

G-POEM was found to be beneficial to improve symptoms and gastric emptying in a substantial percentage of people with severe and refractory gastroparesis.