Nutrition aspects of gastroparesis and therapies for drug-refractory patients.

Gastroparesis, broadly defined as disordered gastric emptying, is a commonly encountered clinical problem. Nutrition problems frequently occur in gastroparesis, primarily due to inadequate oral intake but also due to losses from vomiting or diarrhea. Treatment of gastroparesis may include dietary modification with or without medication. Some patients require supplementation with either enteral or parenteral nutrition for survival. However, many patients with gastroparesis are drug-refractory and invariably do not do well with enteral or parenteral access. Historically, these patients have been without effective therapeutic options. The development of gastrointestinal electrical stimulation has allowed many with drug-refractory gastroparesis to be treated successfully. Enteric electrical stimulation for gastroparesis often corrects many of the nutrition abnormalities, along with improving symptoms and quality of life and reducing costs; for some categories of patients, it may improve survival rates.