Endoscopic Myotomy of the Pylorus to Improve Emptying and Symptoms Trial

Eligibility Criteria

• 1. Male or female, aged 18-75
• 2. Diagnosis of medically refractory gastroparesis by 4 hour non-extrapolated solid phase gastric emptying study completed within 12 months of enrollment. Medical refractoriness is defined by at least 6 months of medical treatment with no significant improvement in baseline symptoms
• 3. Completion of all routine assessments in our multidisciplinary gastroparesis clinic, which includes evaluation by gastroenterology, behavioral health, and nutrition specialists
• 4. Ability to take oral medication and be willing to adhere to the post-procedure dietary and medication regimen
• 5. For females of reproductive potential: use of highly effective contraception for at least 1 month prior to screening and agreement to use such a method during study participation
• 6. Stated willingness to comply with all study procedures and availability for the duration of the study
• 7. Willingness and reasonable expectation that the individual will be able to travel to the study site for the intervention and each scheduled in-person assessment, as well as virtual assessments if necessary
• 8. Be able to speak and read the English language.
• 1. Active use of narcotic pain medication
• 2. Presence of concomitant gastrointestinal transit disorder such as small bowel dysmotility or uncontrolled colonic dysmotility (As defined by clinical judgement or \< 3 bowel movements per week)
• 3. Etiology of gastroparesis is post-surgical
• 4. Pregnancy or lactation
• 5. History of egg allergy
• 6. Prior surgical intervention of the stomach or gastric pylorus
• 7. Current parenteral nutrition
• 8. Uncontrolled coagulopathy (platelet count \<50,000 and INR\>1.5) or use of anticoagulant medications (with the exception of antiplatelet therapy)