Idiopathic Gastroparesis

Aim: to characterize the incidence, clinical features, pathophysiological mechanisms, diagnosis and treatment of patients with idiopathic gastroparesis. Material and methods. The search for sources was carried out in publicly available databases of peer-reviewed scientific literature RSCI, CyberLeninka, PubMed/MEDLINE, Google Scholar in 1990–2025 using the keywords  “idiopathic gastroparesis”, “symptoms”, “pathophysiology”, “diagnosis”, “treatment”, “consensus”. Results. The Consensus of the United European Gastroenterology and European Society for Neurogastroenterology and Motility on gastroparesis (2021) and the Rome Foundation and International Neurogastroenterology and Motility Societies Consensus on idiopathic gastroparesis (2025) define idiopathic gastroparesis (gastroparesis of unknown etiology) as symptoms of nausea and vomiting, often accompanied by postprandial fullness and early satiety, associated with delayed gastric emptying in the absence of mechanical obstruction. According to expert estimates, the incidence of gastroparesis in the USA is 0.16–4 %. Among the possible pathophysiological mechanisms of idiopathic gastroparesis (dysfunction of n. vagus and smooth muscle cells, loss of interstitial cells of Cajal, nNOS, macrophages, expressing heme oxygenase-1, abnormalities of syncytium of PDGFRα + -cells, etc.), autonomic neuropathy with loss of enteric nerves is the most proven. In the diagnosis of idiopathic gastroparesis, 4-hour scintigraphy and 13C breath test are preferred. Consensus recommendations for the idiopathic gastroparesis treatment: nutritional support, from the spectrum of pharmacological and surgical interventions, prokinetics and antiemetics are potentially useful. However, the results of treatment often do not adequately address clinical needs. Conclusion. Large-scale prospective studies of alternative approaches to diagnosis and to individualized methods of idiopathic gastroparesis treatment are needed.