Gastroparesis in the Hospital Setting

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.