Pioglitazone for Idiopathic Gastroparesis

Inclusion Criteria: * Age 18 years or older at registration * Diagnosis of gastroparesis as documented by gastric emptying scintigraphy (4-hour emptying after a low-fat meal with any combination of 2 and 4 hour retention of \>60% and 10% respectively) * Ongoing symptoms referable to gastroparesis (i.e. Nausea and vomiting, bloating, and abdominal pain) * Exclusion of other causes of symptoms such as mechanical gastrointestinal obstruction, uncontrolled esophagitis, peptic ulcer disease, etc. By standard radiographic or endoscopic tests * Females will be required to use adequate contraceptive methods during study participation as determined by the Principal Investigator and the study team members Exclusion Criteria: * Another active disorder, which could explain symptoms in the opinion of the investigator * Age \< than 18 years * Pregnancy or nursing * Previous surgery of the upper gastrointestinal tract, including vagotomy * Another active disorder, which could explain symptoms in the opinion of the investigator * Use of narcotics more than 3 days per week * Significant hepatic injury as defined by significant alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevations of greater than 2 x upper limit of normal (ULN) or a Child-Pugh score of 10 or greater * Serious systemic disease, such as recent myocardial infarction/unstable angina, decompensated congestive heart failure, severe pulmonary disease with dyspnea at rest, or altered mental status from any …