The Management of Gastroparesis Associated Malnutrition

ABSTRACT

Gastroparesis (GP) is a chronic debilitating dysmotility condition characterized by unrelenting nausea, vomiting, bloating, early satiety, postprandial fullness and abdominal pain. Patients with GP also experience other associated conditions including gastroesophageal reflux disease, gastric bezoars, and small bowel bacterial overgrowth. Furthermore, GP is associated with poor quality of life, increased emergency room visits, hospitalizations and subsequent increased health care costs. Currently, the management of GP includes glycemic control, antiemetics, prokinetics and use of gastric-electrical stimulation among others. However, majority of GP patients are at risk for significant nutritional abdnormalities. As such, it is essential to screen and diagnose malnutrition in these patients. Poor oral intake in these patients could be supplemented by enteral tube feeding. Parenteral nutrition, although a last resort is associated with a number of complications and should be used only for short-term. In summary, a systematic approach including initial nutritional screening, diet recommendations, medical therapy, nutritional reevaluation and enteral and parental nutrition should be considered in complex GP patients. This article is protected by copyright. All rights reserved.

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