KOL Conversation on GERD, H. pylori, & Gastroparesis

In this dynamic and metaphor-rich discussion recorded at GI ReConnect, Dr. Braden Kuo, Dr. Kyle Staller, and Dr. David Kunkel—leaders in motility and upper GI care—explore the evolving landscape of gastroparesis management, acid suppression therapy, and H. pylori treatment. The conversation begins with a critical review of the draft AGA guidelines for gastroparesis, highlighting the controversy around conditional recommendations, the strict grading methodology, and the limited number of therapies (such as metoclopramide and erythromycin) that currently meet efficacy thresholds. The panel unpacks how these guidelines may affect clinical decision-making, insurance access, and shared decision-making conversations with patients. Transitioning to acid suppression, they introduce potassium-competitive acid blockers (PCABs) as a new, faster-acting class of medications that overcome some of the practical limitations of PPIs. The group shares real-world scenarios for using PCABs, from on-demand therapy to cases of nighttime reflux or partial PPI responders, while emphasizing the importance of diagnostic clarity via pH monitoring. Finally, they discuss the potential for PCABs to improve H. pylori eradication rates by enhancing antibiotic efficacy in a higher pH environment and simplifying regimens in the face of rising clarithromycin resistance and patient nonadherence. Whether you treat upper GI disorders, motility dysfunction, or functional dyspepsia, this episode offers practical pearls, forward-looking perspectives, and a call to action for improving research and outcomes in underfunded GI disease states.