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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #407098

Research Project: Microbiota and Nutritional Health

Location: Children's Nutrition Research Center

Title: Characteristics and outcomes of patients with gastroparesis using enteral and/or exclusive parenteral nutrition

item PARKMAN, HENRY - Temple University
item BLACKFORD, AMANDA - Johns Hopkins University
item MURRAY, HELEN - Harvard Medical School
item YATES, KATHERINE - Johns Hopkins University
item GROVER, MADHUSUDAN - Mayo Clinic
item MALIK, ZUBAIR - Temple University
item SCHEY, RON - Temple University
item BULAT, ROBERT - Johns Hopkins University
item KOCH, KENNETH - Wake Forest University
item SAROSIEK, IRENE - Texas Tech University Health Science Center
item KUO, BRADEN - Harvard Medical School
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)
item CHUMPITAZI, BRUNO - Children'S Nutrition Research Center (CNRC)
item FARRUGIA, GIANRICO - Mayo Clinic
item MIRIEL, LAURA - Johns Hopkins University
item TONASCIA, JAMES - Johns Hopkins University
item HAMILTON, FRANK - National Institutes Of Health (NIH)
item PASRICHA, PANKAJ - Johns Hopkins University
item MCCALLUM, RICHARD - Texas Tech University Health Science Center
item ABELL, THOMAS - University Of Louisville

Submitted to: Journal of Parenteral and Enteral Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/1/2023
Publication Date: 5/1/2023
Citation: Parkman, H.P., Blackford, A.L., Murray, H., Yates, K.P., Grover, M., Malik, Z., Schey, R., Bulat, R.S., Koch, K.L., Sarosiek, I., Kuo, B., Shulman, R.J., Chumpitazi, B.P., Farrugia, G., Miriel, L., Tonascia, J., Hamilton, F., Pasricha, P.J., McCallum, R.W., Abell, T.L. 2023. Characteristics and outcomes of patients with gastroparesis using enteral and/or exclusive parenteral nutrition. Journal of Parenteral and Enteral Nutrition. 47(4):541-549.

Interpretive Summary: Slow stomach emptying (gastroparesis) can cause severe stomach symptoms that often impact the ability to eat and result in poor nutrition. In some cases, the symptoms can be so severe that those affected need to be fed by a tube into their small intestine or receive nutrition through a vein (IV). In this study we found that of 971 adults with slow stomach emptying, a small percentage (3%) were severely affected and needed these types of artificial nutrition. The problem severely impacted their quality of life. The results point to the unmet need to find treatments for this minority of patients who are most affected by slow stomach emptying and that similar studies need to be done in children.

Technical Abstract: Patients with gastroparesis (Gp) may need enteral nutrition (EN) or exclusive parenteral nutrition (PN). Among patients with Gp, we aimed to (1) identify the frequency of EN and exclusive PN use and (2) explore characteristics of patients using EN and/or exclusive PN compared with those using oral nutrition (ON),including changes over 48 weeks. Patients with Gp underwent history and physical examination, gastric emptying scintigraphy, water load satiety testing (WLST), and questionnaires assessing gastrointestinal symptoms and quality of life (QOL). Patients were observed 48 weeks. Of 971 patients with Gp (idiopathic, 579; diabetic, 336; post–Nissen fundoplication, 51), 939 (96.7%) were using ON only, 14 (1.4%) using exclusive PN, and 18 (1.9%) using EN. Compared with patients receiving ON, patients receiving exclusive PN and/or EN were younger, had lower body mass index, and had greater symptom severity. Patients receiving exclusive PN and/or EN had lower physical QOL but not mental QOL or Gp-related QOL scores. Patients receiving exclusive PN and/or EN ingested less water during WLST but did not have worse gastric emptying. Of those who had been receiving exclusive PN and/or EN, 50% and 25%, respectively, resumed ON at 48-week follow-up. This study describes patients with Gp requiring exclusive PN and/or EN for nutrition support, who represent a small (3.3%) but important subset of patients with Gp. Unique clinical and physiological parameters are associated with this subset and provide insight into the use of nutrition support in Gp.