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Critically ill patients and gut motility: Are we addressing it?
Gastrointestinal (GI) dysmotility is a common problem in the critically ill population. It can be a reflection and an early sign of patient deterioration or it can be an independent cause of morbidity and mortality. GI dysmotility can be divided for clinical purposes on upper GI dysmotility and lowe...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547375/ https://www.ncbi.nlm.nih.gov/pubmed/28828195 http://dx.doi.org/10.4292/wjgpt.v8.i3.174 |
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author | Vazquez-Sandoval, Alfredo Ghamande, Shekhar Surani, Salim |
author_facet | Vazquez-Sandoval, Alfredo Ghamande, Shekhar Surani, Salim |
author_sort | Vazquez-Sandoval, Alfredo |
collection | PubMed |
description | Gastrointestinal (GI) dysmotility is a common problem in the critically ill population. It can be a reflection and an early sign of patient deterioration or it can be an independent cause of morbidity and mortality. GI dysmotility can be divided for clinical purposes on upper GI dysmotility and lower GI dysmotility. Upper GI dysmotility manifests by nausea, feeding intolerance and vomiting; its implications include aspiration into the airway of abdominal contents and underfeeding. Several strategies to prevent and treat this condition can be tried and they include prokinetics and post-pyloric feeds. It is important to note that upper GI dysmotility should be treated only when there are clinical signs of intolerance (nausea, vomiting) and not based on measurement of gastric residual volumes. Lower GI dysmotility manifests throughout the spectrum of ileus and diarrhea. Ileus can present in the small bowel and the large bowel as well. In both scenarios the initial treatment is correction of electrolyte abnormalities, avoiding drugs that can decrease motility and patient mobilization. When this fails, in the case of small bowel ileus, lactulose and polyethylene glycol solutions can be useful. In the case of colonic pseudo obstruction, neostigmine, endoscopic decompression and cecostomy can be tried when the situation reaches the risk of rupture. Diarrhea is also a common manifestation of GI dysmotility and the most important step is to differentiate between infectious sources and non-infectious sources. |
format | Online Article Text |
id | pubmed-5547375 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-55473752017-08-21 Critically ill patients and gut motility: Are we addressing it? Vazquez-Sandoval, Alfredo Ghamande, Shekhar Surani, Salim World J Gastrointest Pharmacol Ther Minireviews Gastrointestinal (GI) dysmotility is a common problem in the critically ill population. It can be a reflection and an early sign of patient deterioration or it can be an independent cause of morbidity and mortality. GI dysmotility can be divided for clinical purposes on upper GI dysmotility and lower GI dysmotility. Upper GI dysmotility manifests by nausea, feeding intolerance and vomiting; its implications include aspiration into the airway of abdominal contents and underfeeding. Several strategies to prevent and treat this condition can be tried and they include prokinetics and post-pyloric feeds. It is important to note that upper GI dysmotility should be treated only when there are clinical signs of intolerance (nausea, vomiting) and not based on measurement of gastric residual volumes. Lower GI dysmotility manifests throughout the spectrum of ileus and diarrhea. Ileus can present in the small bowel and the large bowel as well. In both scenarios the initial treatment is correction of electrolyte abnormalities, avoiding drugs that can decrease motility and patient mobilization. When this fails, in the case of small bowel ileus, lactulose and polyethylene glycol solutions can be useful. In the case of colonic pseudo obstruction, neostigmine, endoscopic decompression and cecostomy can be tried when the situation reaches the risk of rupture. Diarrhea is also a common manifestation of GI dysmotility and the most important step is to differentiate between infectious sources and non-infectious sources. Baishideng Publishing Group Inc 2017-08-06 2017-08-06 /pmc/articles/PMC5547375/ /pubmed/28828195 http://dx.doi.org/10.4292/wjgpt.v8.i3.174 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Minireviews Vazquez-Sandoval, Alfredo Ghamande, Shekhar Surani, Salim Critically ill patients and gut motility: Are we addressing it? |
title | Critically ill patients and gut motility: Are we addressing it? |
title_full | Critically ill patients and gut motility: Are we addressing it? |
title_fullStr | Critically ill patients and gut motility: Are we addressing it? |
title_full_unstemmed | Critically ill patients and gut motility: Are we addressing it? |
title_short | Critically ill patients and gut motility: Are we addressing it? |
title_sort | critically ill patients and gut motility: are we addressing it? |
topic | Minireviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547375/ https://www.ncbi.nlm.nih.gov/pubmed/28828195 http://dx.doi.org/10.4292/wjgpt.v8.i3.174 |
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