Abstract
Gastroparesis is a debilitating disease that is the consequence of a variety of conditions resulting in a significant loss of quality of life. Although many cases are mild, some patients have protracted nausea and vomiting, making it difficult, if not impossible, to maintain their hydration and nutritional status. Furthermore, therapeutic levels of medications, such as prokinetic and antiemetic agents, can be difficult to achieve. The intent of this article is to provide the clinician with suggestions to improve the nutritional status of patients with gastroparesis and offer strategies to deal with the nutritional insults that arise in these unfortunate patients.
Similar content being viewed by others
References and Recommended Reading
Abell TL, Bernstein RK, Cutts T, et al.: Treatment of gastroparesis: a multidisciplinary clinical [review]. Neurogastroenterol Motil 2006, 18:263–283.
Cutts TF, Luo J, Starkebaum W, et al.: Is gastric electrical stimulation superior to standard pharmacologic therapy in improving GI symptoms, healthcare resources, and long-term health care benefits? Neurogastroenterol Motil 2005, 17:35–43.
Krystofiak M, Russell MK, Mueller C: Gastrointestinal Disease. In The A.S.P.E.N. Nutrition Support Core Curriculum: A Case-Based Approach—The Adult Patient. Edited by Gottschlich MM. Silver Spring, MD: American Society for Parenteral and Enteral Nutrition; 2007:163–186.
Ross EA, Koo LC: Improved nutrition after the detection and treatment of occult gastroparesis in nondiabetic dialysis patients. Am J Kidney Dis 1998, 31:62–66.
De Schoenmakere G, Vanholder R, Rottey S, et al.: Relationship between gastric emptying and clinical and biochemical factors in chronic haemodialysis patients. Nephrol Dial Transplant 2001, 16:1850–1855.
Banh, L: Serum Proteins as Markers of Nutrition: What are we treating? Practical Gastroenterol 2006, XXX(10):46. Available at http://www.healthsystem.virginia.edu/internet/digestive. Accessed June 1, 2007.
Fuhrman MP, Charney P, Mueller C: Hepatic proteins and nutrition assessment. J Am Diet Assoc 2004, 1258–1264.
Radigan A: Post-gastrectomy: Managing the nutrition fall-out. Pract Gastroenterol 2004, XXVIII:63. Available at http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June 1, 2007.
Fraser RJ, Horowitz M, Maddox AF, et al.: Hyperglycemia slows gastric emptying in Type I (insulin dependent) diabetes mellitus. Diabetologia 1990, 33:675–680.
Jones KL, Horowitz M, Berry M, et al.: Blood glucose concentration influences postprandial fullness in IDDM. Diabetes Care 1997, 20:1141–1146.
Petrakis IE, Chalkiadakis G, Vrachassotakis N, et al.: Induced-hyperglycemia attenuates erythromycin-induced acceleration of hypertonic liquid-phase gastric emptying in type I diabetic patients. Dig Dis Sci 1999, 17:241–247.
Jones KL, Berry M, Kong MF, et al.: Hyperglycemia attenuates the gastrokinetic effect of erythromycin and affects the perception of postprandial hunger in normal subjects. Diabetes Care 1999, 22:339–44.
Parrish CR, Yoshida C: Nutrition intervention for the patient with gastroparesis: an update. Pract Gastroenterol 2005, XXIX:29. Available at http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June 1, 2007.
Ogorek CP, Davidson L, Fisher RS: Idiopathic gastroparesis is associated with a multiplicity of severe dietary deficiencies. Am J Gastroenterol 1991, 86:423–428.
Hsu JJ, Lee ST, Glena RC, et al.: Gastroparesis syndrome: nutritional sequelae and the impact of dietary manipulation on symptoms. Gastroenterology 1995, 108(4):A17.
Zaidel O, Lin HC. Uninvited Guests: The Impact of Small Intestinal Bacterial Overgrowth on Nutritional Status. Pract Gastroenterol 2003, XXVII(7):27. Available at http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June 1, 2007.
Sanders MK: Bezoars: from mystical charms to medical and nutritional management. Pract Gastroenterol 2004, XXVIII:37. Available at http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June 1, 2007.
Taylor JR, Streetman DS, Castle SS: Medication bezoars: A literature review and report of a case. Ann Pharmacother 1998, 32:940–946.
Corinaldesi R, Stanghellini V, Paparo GF, et al.: Gastric acid secretion and gastric emptying of liquids in 99 male duodenal ulcer patients. Dig Dis Sci 1989, 34:251–256.
Couturier O, Bodet-Milin C, Querellou S, et al.: Gastric scintigraphy with a liquid-solid radiolabelled meal: performances of solid and liquid parameters. Nucl Med Commun 2004, 25:1143–1150.
Maurer AH, Parkman HP: Update on gastrointestinal scintigraphy. Semin Nucl Med 2006, 36:110–118.
Emerson AP: Foods high in fiber and phytobezoar formation. J Am Diet Assoc 1987, 87:1675–1677.
Moore JG, Datz FL, Christian PE, et al.: Effect of body posture on radionuclide measurements of gastric emptying. Dig Dis Sci. 1988, 33:1592–1595.
Javorsky B, Maybee N, Padia SH, Dalkin A. Vitamin D deficiency in gastrointestinal disease. Pract Gastroenterol 2006, XXX(3):52. Available at http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June 1, 2007.
McCray S: Lactose intolerance: considerations for the clinician. Pract Gastroenterol 2003, XXVII(2):21. Available at http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June 1, 2007.
Pawson R, Mehta A: Reiew article: The diagnosis and treatment of haematinic deficiency in gastrointestinal disease. Aliment Pharmacol Ther 1998, 12:687–698.
Robert C, Brown DL: Vitamin B12 deficiency. Am Fam Physician 2003, 67:979–986. Available at http://www.aafp.org/afp/20030301/979.html. Accessed June 1, 2007.
Braunschweig CL, Levy P, Sheean PM, et al.: Enteral compared with parenteral nutrition: a meta analysis. Am J Clin Nutr 2001, 74:534–542.
Bouras EP, Scolapio JS: Gastric motility disorders: Management that optimizes nutritional status. J Clin Gastroenterol 2004, 38:549–557.
Kim CH, Nelson DK: Venting percutaneous gastrostomy in the treatment of refractory idiopathic gastroparesis. Gastrointest Endosc 1998, 47:67–70.
Fontana RJ, Barnett JL: Jejunostomy tube placement in refractory diabetic gastroparesis: a retrospective review. Am J Gastroenterol 1996, 91:2174–2178.
Jacober SJ, Narayan A, Strodel WE, et al.: Jejunostomy feeding in the management of gastroparesis diabeticorum. Diabetes Care 1986, 9:217–219.
Devendra D, Millward BA, Travis SP: Diabetic gastroparesis improved by percutaneous endoscopic jejunostomy. Diabetes Care 2000, 23:426–427.
Maple JT, Petersen BT, Baron TH, et al.: Direct percutaneous endoscopic jejunostomy: outcomes in 307 consecutive attempts. Am J Gastroenterol 2005, 100:2681–2688.
Rumalla A, Baron TH: Results of direct percutaneous endoscopic jejunostomy, an alternative method for providing jejunal feeding. Mayo Clin Proc 2000, 75:807–810.
Fan AC, Baron TH, Rumalla A, et al.: Comparison of direct percutaneous endoscopic jejunostomy and PEG with jejunal extension. Gastrointest Endosc 2002, 56:890–894.
McCray S, Walker S, Parrish CR: Much ado about refeeding. Practical Gastroenterol 2004, XXVIII(12):26. Available at http://www.healthsystem.virgina.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June 1, 2007.
Condron S. Post-PEG feeding: why wait? Pract Gastroenterol 2006, XXX:48. Available at http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June, 1, 2007.
Malone AM: Enteral formula selection: a review of selected product categories. Pract Gastroenterol 2005, XXIX:44. Available at http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June 1, 2007.
Parrish CR: Enteral feeding: the art and the science; Nutr Clin Pract 2003, 18:76.
Parrish CR, McCray S: Enteral feeding: dispelling the myths. Pract Gastroenterol 2003, XXVII:33. Available at http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/resources.cfm. Accessed June 1, 2007.
Muller-Lissner SA, Kamm MA, Scarpignato C, et al.: Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005, 100:232–242.
Voderholzer WA, Schatke W, Muhldorfer BE, et al.: Clinical response to dietary fiber treatment chronic constipation. Am J Gastroenterol 1997, 92:95–98.
Parrish CR, Krenitsky J, McCray S: University of Virginia Health System Nutrition Support Traineeship Syllabus; 2003. Available at http://www.healthsystem.virginia.edu/internet/dietitian/dh/traineeship.cfm. Access June 1, 2007.
Cuoco L, Montalto M, Jorizzo RA, et al.: Eradication of small intestinal bacterial overgrowth and oro-cecal transit in diabetics. Hepatogastroenterology 2002, 49:1582–1586.
Strid H, Simren M, Stotzer P, et al.: Patients with chronic renal failure have abnormal small intestinal motility and a high prevalence of small intestinal bacterial overgrowth. Digestion 2003, 67:129–137.
Stefano M, Malservisl S, Veneto G, et al.: Rifaximin versus chlortetracycline in the short-term treatment of small bowel intestinal bacterial overgrowth. Aliment Pharmacol Ther 2000, 14:551–556.
Van Citters GW, Lin HC: The ileal brake: A fifteen-year progress report. Curr Gastroenterol Rep 1999, 1:404–409.
MacGregor IL, Gueller R, Watts HD, et al.: The effect of acute hyperglycemia on gastric emptying in man. Gastroenterology 1976, 70:190–197.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Parrish, C.R. Nutrition concerns for the patient with gastroparesis. Curr Gastroenterol Rep 9, 295–302 (2007). https://doi.org/10.1007/s11894-007-0033-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11894-007-0033-0