When should I consider referring a patient with gastroparesis to a gastroenterologist for further management?

Consider referring a patient with gastroparesis to a gastroenterologist for specialist advice if initial interventions have not helped or are not appropriate. This includes cases where dietary modifications, symptom management, and pharmacological treatments such as domperidone, erythromycin, or metoclopramide have failed to control symptoms effectively. Referral is particularly important in adults with type 1 diabetes who have gastroparesis and persistent vomiting despite treatment attempts.