Which of the following is a cause of nausea and vomiting related to gastric motility in the enterally fed patient?

• A. Distal obstruction
• B. Anxiety
• C. Gastroparesis
• D. Medications

Answer: (C)

Gastric emptying depends on coordinated gastric motility; when this motility is impaired, contents stay in the stomach longer, leading to nausea and vomiting, especially in someone receiving tube feeding where timely emptying is needed for tolerance. Gastroparesis is the condition of delayed gastric emptying due to impaired gastric motility, occurring without a mechanical blockage, and it directly explains feed intolerance with nausea and vomiting in enterally fed patients. Distal obstruction implies a blockage further along the tract and would present with features of obstruction rather than a primary motility problem of the stomach. Anxiety can contribute to nausea but does not reflect a direct gastric motility impairment. Medications can influence motility as a side effect, but gastroparesis best captures a primary gastric motor dysfunction causing these symptoms.