Total parenteral nutrition (TPN) is a form of nutrition used when there is no other alternative. Patients most likely to require TPN are those with non-functional or dysfunctional gastrointestinal tracts that are unable to absorb the nutrients needed or are intolerant to enteral feedings, such as with small bowel obstruction or multiple abdominal surgeries. Patients who are on chemotherapy and have loss of appetite may also benefit from TPN but usually there are other medications and therapies that should be trialed first. A patient with a gastric ulcer or with cholecystitis should have his/her diet advanced slowly post endoscopy or post cholecystectomy, but it is not a contraindication to oral nutrition.