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Small Bowel Dysmotility.

Soffer1

  • 1Cleveland Clinic Foundation, Gastroenterology Department S40, 9500 Euclid Avenue, Cleveland, OH 44195.

Current Treatment Options in Gastroenterology
|November 30, 2000
PubMed
Summary
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Effective management of intestinal dysmotility involves ruling out obstruction, addressing bacterial overgrowth with antibiotics, and prioritizing nutritional support. Prokinetic agents and specific surgical interventions can also improve patient outcomes.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Digestive System Disorders

Background:

  • Intestinal dysmotility presents complex management challenges.
  • Excluding reversible causes and optimizing nutrition are critical initial steps.

Purpose of the Study:

  • To outline a comprehensive management strategy for intestinal dysmotility.
  • To discuss diagnostic and therapeutic options for severe cases.

Main Methods:

  • Initial assessment includes excluding mechanical obstruction and determining bacterial overgrowth.
  • Nutritional support via enteral feeding is prioritized over total parenteral nutrition (TPN).
  • Pharmacological interventions include antibiotics, prokinetic agents, and potentially octreotide.

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Main Results:

  • Early identification and treatment of bacterial overgrowth with appropriate antibiotics are essential.
  • Enteral nutrition, including jejunal feeding, is preferred for severe dysmotility.
  • Prokinetic agents may alleviate symptoms, especially when gastric dysmotility is present.
  • Venting jejunostomy offers significant benefits for selected patients with intermittent symptoms.

Conclusions:

  • A stepwise approach, starting with reversible causes and nutritional optimization, is key.
  • Pharmacological and surgical options should be considered for refractory cases.
  • Venting jejunostomy is a valuable intervention for specific patient subgroups.