To Determine the Role of Prokinetics in Feed Intolerance in Critically Ill Cirrhosis

1. All patients with chronic liver disease admitted in ICU (Intensive Care Unit) to be screened. 2. Patients fulfilling criteria for feed intolerance to be included in the study. 3. Patients to undergo routine biochemical and hematological testing including CBC, KFT, LFT, PT/INR, electrolytes baseline and daily along with ABG (Arterial Blood gas) analysis. 4. Patients with ascites to be tested for presence or absence of SBP (Spontaneous Bacterial Peritonitis). 5. Cultures to be sent as based on clinical parameter of the patient. 6. All correctable causes for intra abdominal hypertension to be corrected including electrolyte imbalance, grade III ascites, intra abdominal infection. 7. Symptoms- Absent bowel sounds (BS)= no BS detected by auscultation. Vomiting/regurgitation= any visible regurgitation of gastric contents; Diarrhoea= liquid stool \> or =3 times/day; Bowel distension= suspected clinically and radiologically confirmed; Large gastric residual volume (GRV) of \>or =500 ml/24 h on a single day or \> 200ml at any time of the day. 8. Per abdomen findings to be checked daily including presence of bowel sounds, tenderness, development of abdominal distension, abdominal girth monitoring and abdominal pressure monitoring. 9. Patients who develop feed intolerance will be included. 10. Feed intolerance to be defined as per study definition (3 out of 5 symptoms). 11. Measurement of GRV (Gastric residual volume) to be done at 4 hourly interval. 12. Methods for measuring GRV by either gravity drainage by connecting a gastric tube to a drainage bag for 10min or by manual aspiration of content using a 50ml syringe. 13. Once feed intolerance develop than every 6 hourly intra abdominal pressure monitoring and abdominal girth monitoring to be done (24) 14. Intra bladder pressure to be measured using Foleys manometer technique (25). 15. Pressure measured in cm of water to be converted into mm of Hg. 16. X ray abdomen supine to look for bowel distension, defined as more than