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

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 47; no. 4; pp. 541 - 549
• Main Authors: Parkman, Henry P., Blackford, Amanda L., Murray, Helen Burton, Yates, Katherine P., Grover, Madhusudan, Malik, Zubair, Schey, Ron, Bulat, Robert S., Koch, Kenneth L., Sarosiek, Irene, Kuo, Braden, Shulman, Robert J., Chumpitazi, Bruno P., Farrugia, Gianrico, Miriel, Laura, Tonascia, James, Hamilton, Frank, Pasricha, Pankaj J., McCallum, Richard W., Abell, Thomas L.
• Format: Journal Article
• Language: English
• Published: United States 01-05-2023
• Subjects: Enteral Nutrition; gastric emptying; gastroparesis; Gastroparesis - therapy; Humans; idiopathic gastroparesis; Nutritional Support; obesity; Parenteral Nutrition; Quality of Life; enteral nutrition; parenteral nutrition; idiopathic gastroparesis; gastric emptying; gastroparesis; obesity
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1002/jpen.2493

Background
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.
Methods
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.
Results
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.
Conclusions
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.