Enteral nutrition intolerance: Evidence mapping of definitions and assessment practices to inform future gastric...

Enteral nutrition intolerance can limit achievement of nutrition goals, but its definitions and assessment methods vary widely. This review mapped operational definitions and identified evidence gaps relevant to patients after gastrectomy for gastric cancer.

The Web of Science Core Collection was searched for original clinical studies published from 2015 to 2025 that re-ported explicit operational definitions or ascertainment criteria. Study populations, feeding routes, assessment components, incidence rates, and outcomes were charted and synthesized descriptively.

Forty-seven studies were included. Most involved critically ill populations, whereas only three focused on patients after gastric cancer surgery. Definitions used heterogeneous combinations of gastrointestinal symptoms, gastric residual volume, feeding interruption or rate reduction, failure to meet energy targets, and other indicators, with inconsistent thresholds and observation windows. A preliminary three-domain framework was identified: gastrointestinal and dumping-related symptoms, route-appropriate objective indicators, and treatment response or feeding adjustments.

Existing definitions are heterogeneous and largely derived from intensive care settings. Standardized reporting and disease-specific validation are required before a gastric cancer-specific assessment tool can be developed.