Intestinal dysmotility of critical illness

Gastrointestinal dysmotility is a major challenge in critical care medicine as it contributes to reduced caloric and protein intake in patients with major metabolic stressors. The pathophysiology of dysmotility in the ICU is complex and multifactorial. As a dysfunctional gut can lead to systemic sepsis and proinflammatory states, dysmotility in critically ill patients can result in disastrous consequences. Patients with dysmotility require a multifaceted treatment approach that addresses multiple inciting causes and utilizesmultiple pharmacological pathways. In this chapter we review the pathophysiology, the major etiologic causes, and proposed treatments of GI dysmotility in the critically ill.