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World J Gastrointest Pharmacol Ther. Aug 6, 2014; 5(3): 148-155
Published online Aug 6, 2014. doi: 10.4292/wjgpt.v5.i3.148
Published online Aug 6, 2014. doi: 10.4292/wjgpt.v5.i3.148
Pharmacological therapy of feed intolerance in the critically ills
Nam Q Nguyen, Departments of Gastroenterology and Hepatology, Royal Adelaide Hospital, 5000 South Australia, Australia
Nam Q Nguyen, Discipline of Medicine, University of Adelaide, North Terrace, Adelaide, 5000 South Australia, Australia
Author contributions: Nguyen NQ contributed to conception and design, analysis and interpretation of the data, drafting of the article, critical revision of the article for important intellectual content, and final approval of the article.
Correspondence to: Nam Q Nguyen, Associate Professor, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, North Terrace, Adelaide, 5000 South Australia, Australia. quoc.nguyen@health.sa.gov.au
Telephone: +61-88222-5207 Fax: +61-88222-5885
Received: December 12, 2013
Revised: April 24, 2014
Accepted: May 31, 2014
Published online: August 6, 2014
Processing time: 265 Days and 22 Hours
Revised: April 24, 2014
Accepted: May 31, 2014
Published online: August 6, 2014
Processing time: 265 Days and 22 Hours
Core Tip
Core tip: Feed intolerance during critical illness must be promptly recognized and treated due to the associated morbidity and mortality. The current first line treatment for feed intolerance is prokinetic therapy with erythromycin and metoclopramide (alone or in combination), which are highly effective and free of significant adverse effects. Although diarrhoea occurs commonly after combination prokinetic therapy, it is not associated with Clostridium difficile colitis and settled shortly after stopping the treatment. The use of prokinetic therapy over a long period or for prophylactic purpose, therefore, must be avoided and the indication for ongoing use of the drug(s) should be frequently reviewed.