Idiopathic Gastroparesis
ÎUp to 50% of critically ill patients have markedly delayed gastric emptying.
ÎGastroparesis is a recognized complication of a number of endocrine disorders in addition to diabetes. These include hypopituitarism, Addison's disease, hypothyroidism, hyperthyroidism and hyperparathyroidism.
ÎSuspect causes include viral infections and cholecystectomy. Functional Dyspepsia (FD)
ÎThe prevalence of FD is estimated to range between 5 and 12% when strict criteria are used, but liberal criteria may yield prevalences as high as 40%.
ÎThe Rome III criteria for FD specify four specific symptoms, which are thought to originate from the gastroduodenal region:
• postprandial fullness • early satiation • epigastric pain • epigastric burning
ÎIn contrast to IBS, FD is not commonly associated with acute infections.
ÎThere are two sub-categories of FD: • Postprandial distress syndrome [PDS] (meal-induced dyspeptic symptoms) is characterized by postprandial fullness and early satiation.
• Epigastric pain syndrome [EPS] is characterized by epigastric pain and burning. Note: Acid suppressive therapy is suggested for EPS and prokinetic therapy for PDS.
Assessment for Malnutrition
ÎFive percent loss of usual body weight over 3 months or 10% loss over 6 months is indicative of severe malnutrition.
ÎWhen assessing weight change, include hydration status, particularly in those admitted after several days of vomiting, diarrhea, or in diabetic ketoacidosis.
