Can IVIG Help with Gastroparesis?

Gastroparesis is a rare functional disorder affecting normal muscle movement in the stomach. While IVIG is not the primary treatment for gastroparesis, there is growing interest in its potential benefits.

So, can IVIG help with gastroparesis?

That is what we will discuss here as we look closer at gastroparesis and various studies that have evaluated the effectiveness of IVIG for this disorder.

Understanding Gastroparesis

Gastroparesis, or stomach paralysis, is a chronic condition that affects nearly 1% of adults in the US.

This condition interferes with the nerve and muscle activity in your stomach, causing weakness in your gastrointestinal tract and preventing food digestion at a normal rate.

As a result, the food you eat sits longer in your stomach and leads to various digestive symptoms.

Symptoms of Gastroparesis

Some of the most common symptoms of gastroparesis that IVIG might alleviate include:

• Nausea
• Vomiting
• Heartburn
• Acid reflux
• Indigestion
• Malnutrition
• Weight loss
• Constipation
• Abdominal pain
• Loss of appetite
• Feeling full quickly
• Blood sugar fluctuations
• Feeling full for a long time
• Delayed bowel movements
• Bloated or distended stomach
• Changes in blood sugar levels

The symptoms will vary from one person to another. Some will feel more pain due to a lack of digestion, while others won’t experience any noticeable signs.

The type of symptom that IVIG treatment for gastroparesis targets can be related to the underlying cause of the disease.

Causes of Gastroparesis

When studying the effectiveness of IVIG for gastroparesis, scientists found that this condition most commonly occurs when the stomach nerves are damaged. Sometimes, it can even be due to direct damage to the muscles.

What can cause this damage? Here are the most common culprits:

• Diabetes: High blood sugar levels in diabetic patients can cause nerve damage. Almost one-third of people with diabetes experience gastroparesis.
• Surgery: Those who undergo surgery near their stomach can experience post-surgical gastroparesis. This condition happens when the vagus nerve is injured.
• Infections: Viral and bacterial infections of the gastrointestinal tract can also cause gastroparesis.
• Autoimmune Disorders: Autoantibodies that attack your cells may also damage the nerves in your stomach. One of the most effective therapies for autoimmune disorders is IVIG, which might be helpful for gastroparesis.
• Medications: Some medications and recreational drugs can lead to temporary gastroparesis. These drugs work by blocking the nerve signals that activate the stomach muscles.

The less common causes of this condition can include:

• Cystic fibrosis
• Neurological disorders like Parkinson’s disease
• Chronic inflammatory connective tissue disorders like scleroderma

How is Gastroparesis Diagnosed?

Doctors must determine whether gastroparesis is present due to an autoimmune disorder in order to recommend IVIG treatment for you. They can do that by asking about your symptoms, evaluating your health history, and performing various tests such as:

• MRI
• CT scan
• Blood tests
• Upper GI series
• Upper endoscopy
• Capsule endoscopy
• Abdominal ultrasound
• Gastric motility breath test (GEBT)
• Gastric emptying scintigraphy (GES)

After confirming you have gastroparesis, doctors can decide if IVIG is the best treatment for you or whether you can benefit more from another form of therapy.

Treatments for Gastroparesis

Although doctors can’t directly repair the damage causing the problem, they can provide treatments to encourage stomach emptying.
The goal of treatment for gastroparesis is to:

• Hydrate and nourish the body
• Alleviate symptoms and side effects
• Prevent the condition from worsening
• Stimulate contraction in the stomach muscles

Here are some forms of treatment that achieve these goals.

Medications

IVIG is not the first line of therapy for gastroparesis. The primary treatment for this condition is prokinetic agents. These are medications that stimulate gastrointestinal motility.
Some of the most commonly used drugs from this group include:

• Metoclopramide
• Erythromycin

Nutritional Therapy

Nutritional therapy is another form of treatment for gastroparesis besides IVIG. You could consult with a dietician to adjust your diet and make digestion easier. For instance, eating more easily digestible foods.
Doctors may also prescribe you dietary supplements, tube feeding, or TPN to compensate for the missing nutrients in your diet.

Surgery

The last resort is surgery. Surgical procedures modify your stomach to aid digestion.
Some of the most common surgical procedures for gastroparesis include:

• Pyloroplasty
• Gastric bypass

IVIG

Lastly, there is IVIG treatment for gastroparesis. IVIG, or intravenous immunoglobulin therapy, involves administering immunoglobulins intravenously. Immunoglobulins are antibodies that help the immune system fight off infections and diseases.
We don’t yet know the exact mechanism of how IVIG helps with gastroparesis. However, it’s believed to modulate the immune response and reduce inflammation in the gut, leading to improved gastrointestinal motility.
IVIG therapy can also strengthen the body’s immune system, which may influence the nerves and muscles to function more effectively.
 

Can IVIG Treat Gastroparesis: A Look At Studies

We must explore the available research to determine whether IVIG is effective for this gastrointestinal condition. Here are four studies with results that suggest the off label treatment may be beneficial for some patients.

Treating Refractory Gastroparesis with Immunomodulation

Some patients with autoimmune dysautonomia may also develop gastroparesis. In 2016, 11 female patients with this autoimmune disorder and coexisting gastroparesis who didn’t respond well to drugs and surgical interventions participated in a study.
The scientists used IVIG treatment for this type of gastroparesis. They administered mycophenolate mofetil (an immunosuppressive agent) to some patients while giving others a combination of MM and IVIG. Treatment continued for 8 – 12 weeks.
At the end of the study, those who had received IVIG therapy saw the most improvement in their symptoms. An estimated 55% of patients had improvement in vomiting, while 45% experienced less bloating, nausea, and abdominal pain.
This study shows that immunomodulatory therapy can alleviate symptoms in patients with drug and device refractory gastroparesis who have a coexisting autoimmune condition.

Studying the Effects of IVIG on Patients with Symptoms of Drug and Device Refractory Gastroparesis

In a study in 2017, scientists evaluated the effects of IVIG on gastroparesis patients who were refractory to drug and device treatments and had suspected autoimmune gastrointestinal dysmotility.
A total of 14 patients with evidence of immunological abnormality participated in this study. They underwent psychiatric assessments to rule out eating disorders. They received 400 mg/kg of infusions for 12 weeks.
After receiving a course of IVIG treatment for gastroparesis, they saw significant improvements in various symptoms such as nausea, vomiting, early satiety, and stomach pain.
This study is another testament that IVIG may be effective for cases of gastroparesis that do not respond well to other forms of treatment.

Comparing the Effectiveness of IVIG by Itself and Combined with Other Treatments

A study in 2021 compared the effectiveness of IVIG infusion treatment alone and combined with gastric electrical stimulation (GES) and pyloric therapy.
In this study, 112 patients with gastroparesis who were non-responsive to other treatments participated. Patients were divided into three groups:

• One group only received IVIG
• One group received IVIG and GES
• One group received IVIG, GES, and pyloric therapy

After a 12-week course of treatment, scientists evaluated each group. Over 28.6% of participants responded well to IVIG therapy alone for gastroparesis. Results showed that IVIG solo therapy had higher response rates, while combination therapy reduced the duration of treatment.

Evaluating the Response to IVIG Treatment for Gastroparesis

A recent study in 2023 evaluated patient responses to IVIG therapy. Researchers hypothesized that patients with serologic neuromuscular markers will respond better to treatment.
For this research, they evaluated 47 patients who had failed previous treatments with medications and surgical interventions. Patients received 400 mg/kg of IVIG for 12 weeks.
From this group, 14 patients responded well to the treatment and had a higher level of glutamic acid decarboxylase 65 (a serologic marker). They also received IVIG for gastroparesis for longer than 12 weeks.
Results from this study show that extended therapy and the presence of serologic markers might lead to better response rates. However, more clinical studies are needed to confirm these results.
 

How to Receive IVIG Treatment for Gastroparesis?

As you can see from the above studies, IVIG can be a promising option for patients who have not responded to first-line treatments for gastroparesis.
While more studies are needed to determine the efficacy of IVIG for gastroparesis, you can still receive this treatment if your doctor deems it appropriate.
Here are the steps for receiving IVIG therapy:

1. Visit a gastroenterologist and undergo the necessary tests to determine if IVIG is a suitable treatment option for you.
2. Receive a prescription for IVIG.
3. Find an infusion center or at-home infusion service and schedule treatment.
4. Receive treatment and monitor your symptoms.
5. Follow up with your doctor to see if IVIG works for your condition.

Receive IVIG Treatment for Gastroparesis at Home with AmeriPharma™ Specialty Pharmacy

If you’re eligible to receive IVIG for gastroparesis, AmeriPharma™ Specialty Pharmacy can help.
We offer home infusion services and hard-to-find medications to patients with debilitating conditions. You can effectively manage gastroparesis with our full-service coordination, 24/7/365 support, and thorough copay assistance.
Our specialty pharmacy can service over 40 US states and guide you through the process. Contact us now to learn more about our services and receive specialty care at home.