Sep 14, 2025
1:00 PM2:00 PM
Poster Session
P465
HOME PARENTERAL NUTRITION IN PATIENTS WITH GASTROPARESIS: A SINGLE-CENTER RETROSPECTIVE ANALYSIS.
A. Wierzbicka1, D. Mankowska-Wierzbicka2,*, R. Caraballo Araque1, A. Ukleja1
1Cleveland Clinic Florida, Weston, United States, 2Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland, Poznan, Poland
Rationale: Gastroparesis is a motility disorder that may require HPN in refractory cases. This study explores HPN use in gastroparesis to improve nutrition therapy practices.
Methods: We conducted a retrospective single-center review of HPN patients from August 2022 to April 2025 using electronic medical records. Adults (>18 years) with gastroparesis confirmed by gastric emptying test and on HPN for ≥2 months were included. Data on demographics, GP etiology, HPN indications, line types, therapy duration, and complications were analyzed.
Results: Among 167 HPN patients, 9.5% had GP (13 females, 3 males, mean age of 43.5 years). 15 had idiopathic GP, and 1 had diabetic GP. Severe gastric emptying delay (>35% at 4 hours) was in 75%, moderate delay in 18.25%, and mild delay in 6.25%. All patients presented with nausea, vomiting. The mean duration of HPN was 18.9 months, with mean weight gain 25.3 lbs. 9 patients had PICC lines, with 4 receiving long-term PICC, 4 Hickman catheters, 5 double-lumen powerlines, and 3 medi-ports. Infectious complications occurred in 50% ( bacteremia in 7, exit site infection in 1). DVT in 12.5%, with 1 case of a cardiac thrombus. Feeding trials with nasoenteric and J-tubes were attempted in 10 patients but were unsuccessful. Seven patients were on chronic opioid therapy. Therapeutic interventions included G-POEM (n=4) and gastric electrical stimulation with pyloromyotomy (n=1). 4 patients had G tubes for venting, 1 had a G tube for feeding, and 6 had J tubes for feeding or hydration. PN was discontinued in 10 patients due to resumption of oral intake/optimization of therapy in 8 patients, 3 transitioning to an oral diet, 3 undergoing G-POEM, 2 switching to IV fluids, and 2 reverting to enteral feeding.
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Conclusion: This study highlights HPN’s benefits in weight gain and symptom relief in refractory gastroparesis, while noting the risk of infections and the need for personalized treatment.
Disclosure of Interest: None declared