The Challenge of Nutrition in Treating Gastroparesis

Authors

  • Lester Rodríguez Paleo Hospital Docente Clínico Quirúrgico "Hermanos Ameijeiras".
  • Ana Ibis Conesa González Centro Nacional de Atención al diabético. Instituto Nacional de Endocrinología
  • Marisel Machado Lois Hospital Docente Clínico Quirúrgico "Hermanos Ameijeiras".
  • Aley Palau San Pedro Hospital Docente Clínico Quirúrgico "Hermanos Ameijeiras".
  • María Karla López González Hospital Docente Clínico Quirúrgico "Hermanos Ameijeiras".

Keywords:

gastroparesis, scintigraphy, radiopharmaceutical, food

Abstract

Gastroparesis is defined as a delay in gastric emptying due to the absence of mechanical obstruction, associated with symptoms for more than three months. The diagnosis is made by scintigraphic gastric emptying with a radiolabelled food, which seems to be the most reliable and physiological study. Once the diagnosis is done, a nutritional assessment of patients need to be conducted to individualize treatment, always considering initially dietary adjustments that can sometimes relieve symptoms without resorting to drug therapy. In exceptional cases, where enteral nutrition fails to be administered at a rate sufficient to maintain the patient's weight range or because it affected the small bowel and gastric motility, the use of parenteral nutrition may be necessary. The adequate glycemic control is essential in diabetic patients.

Downloads

Download data is not yet available.

Author Biographies

Lester Rodríguez Paleo, Hospital Docente Clínico Quirúrgico "Hermanos Ameijeiras".

Especialista en Medicina Interna. Departamento de Medicina Nuclear

 

Ana Ibis Conesa González, Centro Nacional de Atención al diabético. Instituto Nacional de Endocrinología

Centro Nacional de Atención al diabético.

References

1. Horowitz M, Jones KL, Akkermans LM. Gastric function. In: Horowitz M, Samson M, eds. Gastrointestinal Function in Diabetes Mellitus. Chichester: John Wiley & Sons Ltd; 2004.117-76.

2. Khoo J, Rayner CK, Jones KL, Horowitz M. Pathophysiology and management of gastroparesis. Expert Rev Gastroenterol Hepatol. 2009;3:167-81.

3. Tack J, Lee KJ. Pathophysiology and treatment of functional dyspepsia. J Clin Gastroenterol. 2005;39(5 Suppl 3):S211-S216.

4. Chang J, Rayner CK, Jone KL, Horowitz M. Diabetic gastroparesis-backwards and forwards. J Gastroenterol Hepatol. 2011;26(Suppl 1):46-57.

5. Camilleri M. Clinical practice. Diabetic gastroparesis. N Engl J Med. 2007;356:820-9.

6. Parkman HP, Camilleri M, Farrugia G. Gastroparesis and functional dyspepsia: excerpts from the AGA/ANMS meeting. Neurogastroenterol Motil. 2010;22:113-33.

7. Talley NJ, Young L, Bytzer P. Impact of chronic gastrointestinal symptoms in diabetes mellitus on health-related quality of life. Am J Gastroenterol. 2001;96:716.

8. Parkman H, McCallum R. Gastroparesis. Pathophysiology, presentation and treatment. Clinical Gastroenterology. New York: Springer; 2012. p. 1-9, 25-33, 177-87.

9. Kashyap P, Farrugia G. Diabetic gastroparesis: what we have learned and had to unlearn in the past 5 years. Gut. 2010;59(12):1716-26.

10. Camilleri M, Bharucha A, Farrugia G. Epidemiology, Mechanisms, and management of Diabetic Gastroparesis. Clinical Gastroenterology and Hepatology. 2011;9:5-12.

11. Jung HK, Choung RS, Locke GR. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology. 2009;136:1225-33.

12. Sadiya A. Nutritional therapy for the management of diabetic gastroparesis: clinical review. Diabetes Metab Syndr Obes. 2012;5:329-35.

13. Talley NJ, Young L, Bytzer P. Impact of chronic gastrointestinal symptoms in diabetes mellitus on health-related quality of life. Am J Gastroenterol. 2001;96:716.

14. Abell T, Camilleri M, Donohoe K, Hasler W, Lin H. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. J Nucl Med Technol. 2008;36:44-54.

15. Viramontes BE, Kim DY, Camilleri M, Lee JS, Stephens D. Validation of a stable isotope gastric emptying test for normal, accelerated or delayed gastric emptying. Neurogastroenterol Motil. 2001;13:567-74.

16. Haruma K, Kusunoki H, Manabe N, Kamada T, Sato M. Real-time assessment of gastroduodenal motility by ultrasonography. Digestion. 2008;77(Suppl 1):48-51.

17. Gentilcore D, Hausken T, Horowitz M, Jones KL. Measurements of gastric emptying of low- and high-nutrient liquids using 3D ultrasonography and scintigraphy in healthy subjects. Neurogastroenterol Motil. 2006;18:106-28.

18. Ziessman HA, Chander A, Clarke JO, Ramos A, Wahl RL. The Added Diagnostic Value of Liquid Gastric Emptying Compared with Solid Emptying Alone. J Nucl Med. 2009;50:726-31.

19. Ma J, Rayner CK, Jones KL, Horowitz M. Diabetic gastroparesis: diagnosis and management. Drugs. 2009;69:971-86.

20. Knight LC. Update on Gastrointestinal Radiopharmaceuticals and Dosimetry Estimates. Semin Nucl Med. 2012;42:138-44.

21. Kwiatek MA, Jones KL, Burch WM, Horowitz M, Bartholomeus FDL. Use of Technegas as a radiopharmaceutical for the measurement of gastric emptying. Eur J Nucl Med. 1999;26:903-6.

22. Knight LC: Radiopharmacy aspects of gastrointestinal imaging. Chapter 63. Henkin RE, Boles MA, Dillhay GL, Halama JR, Karesh SM, Wagner RH, Zimmer AM (eds.). Nuclear Medicine. St. Louis: Mosby; 1996. p. 922-32.

23. Gryback P, Hermansson G, Lyrenas E, Beckman KW, Jacobsson H. Nationwide standardization and evaluation of scintigraphic gastric emptying: reference values and comparisons between subgroups in a multicentre trial. Eur J Nucl Med. 2000;27:647-55.

24. Malmud LS, Fisher RS, Knighty LC, Rock E. Scintigraphic Evaluation of Gastric Emptying. Semin Nucl Med. 1982;12:116-25.

25. Bharucha AE, Camilleri M, Forstrom LA, Zinsmeister AR. Relationship between clinical features and gastric emptying disturbances in diabetes mellitus. Clin Endocrinol (Oxf). 2009;70:415-20.

26. Datz FL. Considerations for accurately measuring gastric emptying. J Nucl Med. 1991;32:881-4.

27. Türkan E, Doğan AS, Özden Ü, Hatice D. In Vitro Evaluation of Tc-99m Radiopharmaceuticals for Gastric Emptying Studies. Molecular Imaging and Radionuclide Therapy. 2014;23(1):21-4.

28. Camilleri M, Bharucha AE, di Lorenzo C, Hasler WL, Prather CM. American Neurogastroenterology and Motility Society consensus statement on intraluminal measurement of gastrointestinal and colonic motility in clinical practice. Neurogastroenterol Motil. 2008;20:1269-82.

29. Knight LC, Kantor S, Doma S, Parkman HP, Maurer AH. Egg labeling methods for gastric emptying scintigraphy are not equivalent in producing a stable solid meal. J Nucl Med. 2007;48:1897-900.

30. Ziessman HA, Bonta DV, Bonta D, Ravich W. Experience with a new standardized 4-hr gastric emptying protocol. J Nucl Med. 2007;48:568-72.

31. Hyett B, Martinez FJ, Gill BM, Mehra S, Lembo A, Kelly CP, et al. Delayed radionucleotide gastric emptying studies predict morbidity in diabetics with symptoms of gastroparesis. Gastroenterology. 2009;137(2):445-52.

32. Jian R, Ducrot F, Ruskone A, Chaussade S, Rambaud JC. Symptomatic, radionuclide and therapeutic assessment of chronic idiopathic dyspepsia. Dig Dis Sci. 1989;34:657-64.

33. Galil MA, Critchley M, Mackie CR. Isotope gastric emptying tests in clinical practice: expectation, outcome, and utility. Gut. 1993;34:916-9.

34. Bouras EP, Vazquez Roque MI, Aranda-Michel J. Gastroparesis: from concepts to management. Nutr Clin Pract. 2013 Aug;28(4):437-47.

35. Parrish C, McCay S. Gastroparesis and Nutrition: The Art. Practical gastroenterology. 2011;35(9):26-41.

36. Rodríguez L, Conesa A, Nuez M, Machado M, López MK. Estudio centellográfico del vaciamiento gástrico con estaño coloidal. Revista Cubana Med. 2015;54(1):58-66.

37. Parrish CR. Nutrition concerns for the patient with gastroparesis. Curr Gastroenterol Rep. 2007;9(4):295-302.

38. Olausson EA, Störsrud S, Grundin H, Isaksson M, Attvall S, Simrén M. A small particle size diet reduces upper gastrointestinal symptoms in patients with diabetic gastroparesis: a randomized controlled trial. Am J Gastroenterol. 2014 Mar;109(3):375-85.

39. Homko CJ, Duffy F, Friedenberg FK, Boden G, Parkman HP. Effect of dietary fat and food consistency on gastroparesis symptoms in patients with gastroparesis. Neurogastroenterol Motil. 2015 Apr;27(4):501-8.

40. Parrish CR. Nutritional considerations in the patient with gastroparesis. Gastroenterol Clin North Am. 2015 Mar;44(1):83-95.

41. Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L. Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013 Jan;108(1):18-37.

42. Bosca M, Martí. L, Mínguez. M. Aproximación diagnóstica y terapéutica al paciente con gastroparesia. Gastroenterol Hepatol. 2007;30(6):351-9.

Downloads

Published

2016-01-07

How to Cite

1.
Rodríguez Paleo L, Conesa González AI, Machado Lois M, Palau San Pedro A, López González MK. The Challenge of Nutrition in Treating Gastroparesis. Acta Médica [Internet]. 2016 Jan. 7 [cited 2025 May 24];17(1). Available from: https://revactamedica.sld.cu/index.php/act/article/view/786

Issue

Vol. 17 No. 1 (2016): enero-junio

Section

Artículo de revisión

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:

  1. Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
  2. Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
  3. Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).