Gastrointestinal dysmotility: Evidence and clinical management

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dc.contributor.authorChapman, M.
dc.contributor.authorNguyen, Q.
dc.contributor.authorDeane, A.
dc.date.issued2013
dc.description.abstractPurpose of review: Gastrointestinal dysmotility and dysfunction underlie our difficulties in providing adequate nutrition by the enteral route to our critically ill patients. Recent findings: Recent studies have quantified gastric emptying and nutrient absorption. Slow gastric emptying is common and probably mediated by cholecystokinin and reduced active ghrelin concentrations. The cause of impaired nutrient absorption is not yet fully understood but may be related to small intestinal blood flow and/or mucosal factors. The absorption of the different macronutrients may be affected in different ways both by critical illness and by therapies. A better understanding of this may optimize the design of nutrient formulations in the future. New treatment modalities for gastrointestinal dysfunction are being investigated and include small intestinal feeding, nonpharmacological options such as acupuncture, and drugs including novel motilin receptor agonists, and opioid antagonists. Summary: We are gradually developing a better understanding of how the gut works during critical illness, which has implications for optimizing the delivery of nutrition and thereby improving nutritional and clinical outcomes.
dc.description.statementofresponsibilityChapman, Marianne J.; Nguyen, Nam Q.; Deane, Adam M.
dc.identifier.citationCurrent Opinion in Clinical Nutrition and Metabolic Care, 2013; 16(2):209-216
dc.identifier.doi10.1097/MCO.0b013e32835c1fa5
dc.identifier.issn1363-1950
dc.identifier.issn1473-6519
dc.identifier.orcidChapman, M. [0000-0003-0710-3283]
dc.identifier.orcidNguyen, Q. [0000-0002-1270-5441]
dc.identifier.orcidDeane, A. [0000-0002-7620-5577]
dc.identifier.urihttp://hdl.handle.net/2440/82128
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.relation.grantGSK962040
dc.rights© 2013 Lippincott Williams & Wilkins, Inc.
dc.source.urihttp://journals.lww.com/co-clinicalnutrition/Abstract/2013/03000/Gastrointestinal_dysmotility___evidence_and.16.aspx
dc.subjectIntestine, Small
dc.subjectHumans
dc.subjectGastrointestinal Diseases
dc.subjectCritical Illness
dc.subjectNaltrexone
dc.subjectCholecystokinin
dc.subjectMotilin
dc.subjectGastrointestinal Agents
dc.subjectEnteral Nutrition
dc.subjectEvidence-Based Medicine
dc.subjectGastric Emptying
dc.subjectQuaternary Ammonium Compounds
dc.subjectRandomized Controlled Trials as Topic
dc.subjectGhrelin
dc.titleGastrointestinal dysmotility: Evidence and clinical management
dc.typeJournal article
pubs.publication-statusPublished

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