Inclusion Criteria:

• Male or female, ages 18-70 years.
• Symptoms of chronic nausea or vomiting compatible with gastroparesis (idiopathic or diabetic) must be present for at least one year (does not have to be contiguous) prior to registration with mean total Gastroparesis Cardinal Symptom Index (GCSI) score of ≥ 2.3.
• Refractory gastroparesis, defined using our previously published data5, as a failure to improve by at least 1 point on the GCSI scale over the last 6 months, despite an adequate trial of one or more standard prokinetics (metoclopramide, erythromycin, prucalopride), antinauseants  (5-HT3  antagonists, promethazine,  prochlorperazine, dronabinol), or neuromodulators (mirtazapine, buspirone).
• Moderate to severe delay in gastric emptying, defined as > 25% solid retained at 4 hours. Gastric emptying scintigraphy will be performed within 6 months of registration.
• No evidence of mechanical obstruction based on upper GI endoscopy or barium series within 2 years of registration.

Exclusion Criteria:

• Another active disorder which could explain symptoms in the opinion of the investigator.
• Gastric retention of solids at 4 hours < 25%.
• Ongoing use of prokinetic agents (e.g., metoclopramide, erythromycin, prucalopride) or drugs that slow down gastric emptying (tricyclic antidepressants, anti-cholinergic agents and narcotics).
• Significant systemic illness such as chronic renal failure or liver disease as defined by Child-Pugh score of 10 or greater.
• Poorly controlled diabetes with HbA1c of greater than 10% at time of screening.
• New medications for gastroparesis-related symptoms started within 1 month prior to registration.
• Pregnancy or nursing.
• Failure to give informed consent.
• Any other condition, which in the opinion of the investigator would impede compliance or hinder completion of the study.