Management of gastroparesis-associated malnutrition.

Autor: Bharadwaj S; Department of Gastroenterology/Hepatology, Center for Human Nutrition, Cleveland Clinic Foundation, College of Osteopathic Medicine Cleveland, Ohio, USA., Meka K; Department of Gastroenterology/Hepatology, Michigan State University, East Lansing, MI, USA., Tandon P; Department of Gastroenterology/Hepatology, Michigan State University, East Lansing, MI, USA., Rathur A; Department of Gastroenterology/Hepatology, Michigan State University, East Lansing, MI, USA., Rivas JM; Department of Gastroenterology/Hepatology, Cleveland Clinic, West Palm Beach, Florida, USA., Vallabh H; Department of Gastroenterology/Hepatology, Center for Human Nutrition, Cleveland Clinic Foundation, College of Osteopathic Medicine Cleveland, Ohio, USA., Jevenn A; Department of Gastroenterology/Hepatology, Center for Human Nutrition, Cleveland Clinic Foundation, College of Osteopathic Medicine Cleveland, Ohio, USA., Guirguis J; Department of Gastroenterology/Hepatology, Center for Human Nutrition, Cleveland Clinic Foundation, College of Osteopathic Medicine Cleveland, Ohio, USA., Sunesara I; University of Mississippi Medical Center, Jackson, Mississippi, USA., Nischnick A; Department of Gastroenterology/Hepatology, Center for Human Nutrition, Cleveland Clinic Foundation, College of Osteopathic Medicine Cleveland, Ohio, USA., Ukleja A; Department of Gastroenterology/Hepatology, Cleveland Clinic, West Palm Beach, Florida, USA.
Jazyk: angličtina
Zdroj: Journal of digestive diseases [J Dig Dis] 2016 May; Vol. 17 (5), pp. 285-94.
DOI: 10.1111/1751-2980.12344
Abstrakt: Gastroparesis (GP) is a chronic debilitating dysmotility characterized by unrelenting nausea, vomiting, bloating, early satiety, postprandial fullness and abdominal pain. Patients with GP 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 healthcare costs. Currently, the managements of GP consist of glycemic control, antiemetics, prokinetics and the use of gastric electrical stimulation. However, most GP patients are at risk for significant nutritional abnormalities. As such, it is essential to screen and diagnose malnutrition in these patients. Poor oral intake in such 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 the short term. In summary, a systematic approach including initial nutritional screening, diet recommendations, medical therapy, nutritional re-evaluation and enteral and parental nutrition should be considered in complex GP patients.
(© 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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