Chapter 26: GI Disease

Question 1

What are the medical managements of Gastroparesis?

Answer 1

Antiemetics and prokinetic agents may reduce symptoms with significant N & V (scheduled dosing is best)

• Metoclopramide (prokinetic): most commonly used bc of its rapid onset of action and efficacy; take NO longer than 12 weeks d/t risk of irreversible tardive dyskinesia
• IV Erythromycin (prokinetic)
• Domperidone: Not commercially available in the US
• Cisapride: Withdrawn from US market d/t associated cardiac arrhythmia

Question 2

What are other oral nutrition interventions with Gastroparesis?

Answer 2

• SFM
• Use liquid calories
• Maximize glucose control
• Medications
• Fat in liquids should be tolerated before restricting them
• Treat SIBO
• Monitor & Replace: Iron, Vitamin B12, Calcium, Vitamin D