Guidelines

Guidelines for Artificial Nutrition Support

Introduction

One third of hospital patients are affected by moderate or severe malnutrition. Malnutrition impairs immunity, organ and muscle function; it results in weak mus-cles that fatigue more readily, including muscles of respiration and locomotion. Malnourished patients are withdrawn and apathetic and are less able to co-operate in their management. The restoration of body tissues occurs much more slowly than weight loss, especially in ill or septic pa-tients. Studies have demonstrated in-creased morbidity and mortality in malnourished patients, and malnutrition is associated with prolonged hospital stay 4. Conversely nutritional support under these circumstances has resulted in reduced morbidity, mortality and hospital stay.

Gastroenterologists (physicians and surgeons) are responsible for the management of patients with intestinal failure, the placement of percutaneous enteral feeding devices, and they are increasingly involved in the organisation of nutrition support services within the hospital. Consequently gastroenterologists must be able to identify malnourished patients and those at nutritional risk, arrange appropriate nutritional intervention, supervise and monitor treat-ment in the hospital, and when indicated in the home.

Examples of patients who need nutritional assessment include: those with gastrointestinal disease (inflammatory bowel disease, chronic liver disease, cystic fibrosis, and some gastrointestinal malignancies), patients with swallowing disorders (chronic neurological disease and oropharyngeal disorders), and patients with severe anorexia.

Guidelines for Artificial Nutrition Support (27K)

British Society of Gastroenterology, 3 St Andrews Place,
Regent's Park,
London NW1 4LB
Telephone: 020 7935 2815
Fax: 020 7487 3734
email: bsg@mailbox.ulcc.ac.uk

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