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Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
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Summary

Gastroparesis (GP) in hospitalized patients presents challenges in diagnosis and management. This review covers mechanisms, diagnosis, and treatments for GP and feeding intolerance in critical illness.

Keywords:
antiemeticsdigestive symptomsenteral nutritiongastrointestinal motilitygastroparesismalnutritionnutrition therapyprokineticsvomiting

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Area of Science:

  • Gastroenterology
  • Critical Care Medicine
  • Clinical Nutrition

Background:

  • Gastroparesis (GP) is frequently observed in hospitalized patients, often necessitating admission due to refractory vomiting, dehydration, and malnutrition.
  • Tube feeding intolerance is a common indicator of gastric dysmotility, particularly in critically ill individuals.
  • Diagnosing and managing GP in hospitals is complex, with diagnostic tests frequently deferred due to patient intolerance or disease severity.

Purpose of the Study:

  • To review the current understanding of gastroparesis mechanisms and feeding intolerance in critical illness.
  • To outline diagnostic approaches for GP in the hospital setting.
  • To discuss medical therapies and nutritional interventions for managing GP and improving enteral nutrition delivery.

Main Methods:

  • This is a review article, synthesizing current knowledge from existing literature.
  • The review focuses on clinical scenarios, risk factors, diagnostic challenges, and therapeutic strategies.
  • Evidence from studies on medical management and nutritional interventions for GP and feeding intolerance is considered.

Main Results:

  • Gastric dysmotility and gastroparesis significantly complicate nutritional support in critically ill patients.
  • Clinical assessment and risk factor identification are often primary diagnostic tools for GP in hospitalized patients.
  • Management strategies include prokinetic and antiemetic medications, nutritional therapy, and optimizing enteral nutrition delivery, potentially beyond the stomach.

Conclusions:

  • Effective management of gastroparesis and feeding intolerance is crucial for optimizing outcomes in critically ill patients.
  • Timely and adequate enteral nutrition is a key therapeutic goal, requiring tailored interventions when gastric emptying is delayed.
  • Further research into mechanisms and advanced interventions may improve patient care and nutritional support in hospital settings.