Overview

• Released Sept. 19, 2025, and published in Gastroenterology, the guideline is presented as a clinical tool rather than a policy directive.
• For diagnosis, the panel recommends a four-hour solid-meal gastric emptying scintigraphy in place of two-hour or shorter tests.
• For initial pharmacologic therapy, metoclopramide or erythromycin is considered appropriate.
• The AGA suggests against several options as first-line or routine care, including domperidone, prucalopride, aprepitant, nortriptyline, buspirone, cannabidiol outside trials, botulinum toxin injection, G-POEM, and gastric electrical stimulation, and makes no recommendation on surgical pyloric procedures.
• The panel stresses individualized care shaped by patient preferences, cites major research gaps and inconsistent disease definitions, and notes that public input informed the recommendations.