Gastroparesis: nausea, lightheadedness or occasional vomiting

I have severe gastroparesis and can't eat enough to maintain so I am on TPN therapy. I suffer from chronic nausea but am allergic to almost all the medication they prescribe for it: reglan, zofran, compazine, promethazine, scolpamine patch, hydroxyzine and even THC. Is anyone aware of any other antinausea medications or even off label medications that help.

A little history, I was diagnosed with gastroparesis in January. Prior to waking up in December 2025 and unable to drink water, I was perfectly healthy with no symptoms. By February they did Gpoem surgery after only doing 2 tests to say I had gastroparesis. The gpoem itself worked but didnt address my inability to eat. That's were the TPN comes in. They have done no other tests and said I need a neurogastro motility specialist but I can't find one to take me. They said my gallbladder was bad and just took that out. If it wasn't for my PCP trying to help me, I dont know where I'd be. By the grace of God I am alive and want to continue to thrive.

If you have read all this, thank you and if you know of any other antinausea meds that might be worth trying or even a neurogastro that could help me, I welcome your insight.
Thank you.

@jneener - welcome to Mayo Clinic Connect. Having a tough time getting enough nutrition and also having chronic nausea, and no remedy due to reactions to the nausea medications, sounds really rough.

Here is some Mayo Clinic information on this condition that may be useful:

- Gastroparesis https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787

I am glad that you like the work your PCP has done trying to help you. If you have any other avenues of finding the specialist your GI medical professional suggested, it might give you a second opinion that would be useful and help ease your mind.

What kind of reaction do you have when you take the antinausea medications you listed? Does your GI team or your PCP have any other suggestions for antinausea medications or techniques that might help you?

@lisalucier
With the antinausea meds I suffer from akathisia. As for the symptoms and treatment of gastroparesis I am pretty well versed. I am trying to get a neurogastro motility doctor who will take me even for a second opinion but I keep getting turned down, including Mayo.

My GI team has said there is nothing more they can do since they are limited in what they can do and said I need a neurogastro motility specialist which they are not. As for them and my PCP, they are at a loss as to what to prescribe.

@jneener
I know this sounds weird but it helps my nausea. When I have nausea I get a couple alcohol pads/swabs (rubbing alcohol) and smell it for a few minutes,for some reason the smell of rubbing alcohol makes my nausea go away. Peppermint candy/gum also helps my nausea.

@tjanet thank you. I do use them.

I would consider Domeperidone for your nausea. You need to get it from a Canadian pharmacy. Your doctor can order it. You need special permission in the USA to get it. It’s a very common med for people with Parkinson’s. Gastroparesis commonly occurs with Parkinson’s.
Contact me if you need more information.

@coho222 thank you for that information. My doctors here say they will not prescribe it because of the heart issues it could cause. I didn’t realize it also helped with nausea.

Domeperidone is prokinetic and antiemetic. And yes, there is a very small chance of increasing QTc intervals which can lead to arythmias. I have been taking 20mg three times a day for many years. I have had no problems with this medication. You could also try ginger powder capsules 550 mg three times daily. Or chew on raw ginger.

@coho222 thank you!

@jneener - Hi, I'm not sure where you are located but the below site offers a list of gastro motility doctors or they might be able to assist. I know of one in CA but like I said, I do not know where you are located. Also, I just have to say that your GI team really should be more helpful to you in finding a motility doctor. They have to belong to a GI organization and/or attend conferences where they have access to several GI/Motility doctors.
https://iffgd.org/resources/ddh-chat/living-with-gastroparesis/