Nutrition and Gastrointestinal Disorders
David Heber, Zhaoping Li in Primary Care Nutrition, 2017
The idea of providing all nutrition through enteral supplements rather than foods is called exclusive enteral nutrition, and it is used for active disease. It was first used in 1973 in adults with Crohn’s disease resistant to other therapies (Voitk et al. 1973). Supplemental enteral nutrition may also be used to maintain a disease remission or to achieve adequate weight gain and growth (O’Sullivan and O’Morain 2006). Although research studies have confirmed its effectiveness in therapy, outcomes of this approach, when implemented in patients, are highly variable. Exclusive enteral nutrition is the initial therapy option in active Crohn’s disease. Parenteral nutrition is reserved to only being considered as an alternative method of nutrition for those who cannot tolerate enteral nutrition or during perioperative periods.
Nutritional Considerations
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
Parenteral nutrition is rarely required in patients with head and neck cancer as most patients have an accessible and functioning gastrointestinal tract. National data suggests an incidence of <1% for patients with head and neck cancer.67 Parenteral nutrition may be used as a temporizing measure in patients with head and neck cancer who have obstructive tumours, making placement of an enteral feeding tube impossible. It may also be used for patients who have a chyle leak that has not responded to oral or enteral diet modification. Parenteral nutrition should be considered for individuals who are malnourished or at risk or malnutrition and have inadequate or unsafe oral/enteral nutritional intake and have a non-functional, inaccessible or leaking gastrointestinal tract.21 Parenteral nutrition can be stopped once adequate oral or enteral nutrition is tolerated and withdrawal should be planned and stepwise with a daily review of the patient’s progress.
Improving the competence of pharmacist students through international lecturers
Elida Zairina, Junaidi Khotib, Chrismawan Ardianto, Syed Azhar Syed Sulaiman, Charles D. Sands, Timothy E. Welty in Unity in Diversity and the Standardisation of Clinical Pharmacy Services, 2017
In addition, the international lecturer created and gave handouts appropriate to the research topic. Compared with the teaching materials from internal lecturers (in the previous year), teaching materials prepared by the international lecturer were more complete. Furthermore, the international lecturer not only mentioned about the standard procedure of aseptic technique, but also provided practical examples from his own country. A very significant additional material was related to the discussion of the definition, scope, sources of contaminant in aseptic process, as well as how to minimize each type of contaminants present. The other materials were related to TPN, and there were additional materials in the form of making parenteral nutrition calculation made of the products made in the pharmaceutical industry. The enrichment related to the parenteral nutrition formulations was very significant, because it discussed the content of not only glucose, amino acids, and lipids but also vitamins, antioxidants, and minerals.
Management of COPD patients during COVID: difficulties and experiences
Published in Expert Review of Respiratory Medicine, 2021
Mario Cazzola, Josuel Ora, Andrea Bianco, Paola Rogliani, Maria Gabriella Matera
Hospitalized patients with COVID-19 need prompt and appropriate nutritional intervention because sarcopenia induced by a decrease in weight and muscle mass may appear due to prolonged hospitalization that often causes protracted immobilization with consequent catabolism. This risk is even higher in COPD patients who often have a relatively high prevalence of malnutrition and sarcopenia [77]. All patients admitted with COVID-19 should have their nutritional status assessed. According to the European Society for Clinical Nutrition and Metabolism expert statement, nutritional intervention must be considered as an integral part of the approach to patients with SARS-CoV-2 infection [78]. This statement has proposed 10 recommendations for managing nutritional care in COVID-19 patients highlighting that all elderly, frail and comorbid subjects, including those with COPD, should receive nutritional therapy. If the patient cannot be fed satisfactorily with enteral nutrition, it is necessary to begin parenteral nutrition.
A new perspective of the risk of caustic substance ingestion: the outcomes of 468 patients in one North Taiwan medical center within 20 years
Published in Clinical Toxicology, 2021
Yu-Jhou Chen, Chen-June Seak, Shih-Ching Kang, Tsung-Hsing Chen, Chien-Cheng Chen, Chip-Jin Ng, Chao-Wei Lee, Ming-Yao Su, Hsin-Chih Huang, Pin-Cheng Chen, Chun-Hsiang Ooyang, Sen-Yung Hsieh, Hao-Tsai Cheng
Proton pump inhibitors or H2 antagonists were prescribed to treat caustic injury. Patients received parenteral nutrition without oral intake until their clinical status was regarded as stable. In cases of suspected infection, blood cultures were obtained before the administration of antibiotics (gentamicin and first-generation cephalosporins). Once destabilization or respiratory difficulty was encountered, a patient was transferred to the ICU for critical care. Follow-up EGD was performed if indicated. After discharge, patients were followed up in the outpatient clinic for at least 6 months. Although the exact treatment strategies might have been altered individually according to different clinical conditions, the major principles for similar cases did not change significantly during the past 20 years at our center.
Gastrointestinal manifestations of primary immune deficiencies in children
Published in International Reviews of Immunology, 2018
Naila Nazi, Fani Ladomenou
This is a rare X-linked syndrome due to a mutation in transcription factor forkhead box protein (FOXp3) affecting T-regulatory cells which leads to autoimmunity.42 IPEX is characterized by a triad of immune dysregulation, polyendocrinopathy (usually Type 1 diabetes mellitus) and enteropathy. This is an autoimmune disorder that affects males and presents in the first year of life.43 Children are affected by watery diarrhea, eczema, autoimmune hemolytic anemia, thrombocytopenia and neutropenia. Many patients require total parenteral nutrition. Patients usually die in childhood and the only cure is bone marrow transplantation. Histopathology of the small bowel in patients with IPEX syndrome has shown severe villous atrophy and mucosal erosion with lymphocytic infiltrates of the submucosa or lamina propria.44
Related Knowledge Centers
- Gastrointestinal Tract
- Glucose
- Amino Acid
- Lipid
- Intravenous Therapy
- Compounding
- Salt
- Vitamin
- Mineral
- Peripherally Inserted Central Catheter