Gastroparesis: Delayed gastric emptying without mechanical obstruction

Current management includes:

• IV fluids
• Dopamine receptor antagonists: Prochlorperazine, promethazine

• Ondansetron
• Prokinetics: metoclopramide

Haloperidol Undermining Gastroparesis Symptoms (HUGS)

• Retrospective case matched observational study
• 52 patients who received 5mg IM haldol for symptoms of gastroparesis secondary to Diabetes Mellitus that was formally diagnosed on gastric motility test
• Case matched to their own last visit for similar complaint

Limitations: Not blinded or randomized, single site study with no real control group

Conclusion: Consider haloperidol as an opioid sparing pharmacologic intervention in patients with known or strongly suspected gastroparesis. 

• But remember prolonged QTc as a potential complication, especially in a potentially hypokalemic/hypomagnesemic vomiting patient!

References

Ramirez, R., P. Stalcup, B. Croft, and M. A. Darracq. "Haloperidol Undermining Gastroparesis Symptoms (HUGS) in the Emergency Department." The American Journal of Emergency Medicine. U.S. National Library of Medicine, n.d. Web. 14 May 2017.