Surgical & Gastrointestinal Patients

Example cases for nutrition support

Cancer Anorexia Nutrtion support

Tube feeding in surgical and gastrointestinal patients

Managing the risk of malnutrition is important when dealing with surgical patients and those with gastrointestinal diseases. Perioperative nutrition should be considered to maintain a good nutritional status – not least to be able to avoid postoperative complications but also to trigger positive effects on the general well-being of the patient.1
Malnutrition plays a decisive role as an independent risk factor regarding postoperative complications. Gastrointestinal diseases like Crohn’s disease also present nutritional risk, and inversely nutrition can play a major role coping with such diseases. Enteral nutrition can help to maintain and improve the nutritional status, which in addition has positive effects on the patients’ quality of life.2,3

 

 

The following four example cases illustrate how different patients undergoing surgery and/or treatment for gastrointestinal diseases may benefit from tube feeding:

 

Clinical summary: Presentation/Clinical history

 

Mrs M, 38 years, teacher, current weight: 53.6 kg (BMI: 19.9 kg/m2)

 

Diagnosis: Admitted as an emergency due to a perforated bowel 

Past medical history: cow’s milk protein allergy (CMPA), constipation

BMI low, at nutritional risk

 

Mrs M -surgery patient

Mrs M met her nutritional requirements within 3 days of surgery using Fresubin Soya Fibre despite having a cow's milk protein allergy.

Outcome2 months post discharge

  • Mrs M is back to normal routine and back at work
  • Weight remains stable
  • Progressed to a normal diet after discharge with no further complications

 

 

Download the complete and detailed patient case here

Patient cases Bowel Surgery.pdf

Download the complete and detailed patient case here

Filename
Patient cases Bowel Surgery.pdf
Size
1 MB
Format
pdf

Clinical summary: Presentation/Clinical history

 

Mr N, 19 years, student, current weight: 64.7 kg (BMI: 21.1 kg/m2)

 

Diagnosis: Cystic fibrosis admitted for a lung transplant

Past medical history: Cystic fibrosis, previous PEG in childhood

Poor oral intake 

 

Mr N - patient with cystic fibrosis

Mr N after 10 days recovering well and mobile on ward with assistance.

Outcome2 months later

  • Outpatient, lung transplant has been a success
  • Rehabilitated well and due to go back to his studies in the next few weeks
  • Oral intake continues to improve and weight stable at 63.9 kg
  • Continue with supplemental gastrostomy feeding via PEG on Fresubin 2 kcal HP Fibre and encouragement of fortified foods

 

 

Download the complete and detailed patient case here

Patient case After lung transplantation.pdf

Download the complete and detailed patient case here

Filename
Patient case After lung transplantation.pdf
Size
1 MB
Format
pdf

Clinical summary: Presentation/Clinical history

 

Mrs P, 65 years, retired nurse, current weight: 98 kg (BMI: 36.0 kg/m2)

 

Diagnosis: Myocardial infarction and subsequent cardiac surgery

Past medical history: angina, hypertension, high cholesterol

No weight loss, not progressing to oral diet following surgery

 

Mrs P - Patient with cardiac surgery

Short-term supplemental nasogastric tube feeding was able to optimise Mrs P’s nutritional status.

Outcome1 month post discharge

  • Mrs P is back to her normal self. She is actively trying to live a healthier lifestyle and has intentionally lost 2 kg since discharge from hospital
  • Weight approx. 95 kg, BMI 34.9 kg/m2 and is keen to continue this in the long term

 

 

Download the complete and detailed patient case here

Patient case Cardiac surgery.pdf

Download the complete and detailed patient case here

Filename
Patient case Cardiac surgery.pdf
Size
1 MB
Format
pdf

Clinical summary: Presentation/Clinical history

 

Mr R, 43 years, banker, current weight: 66.4 kg (BMI: 20.2 kg/m2)

 

Diagnosis: Crohn’s disease, admitted for surgical assessment

Past medical history: Crohn’s disease (8 years), inflammatory colon
stricture (18 months ago), osteoporosis

Weight loss 12.1% in past 3 months

Mr R - patient with Crohn's disease

Exclusive enteral nutrition for 9 days to induce remission in Mr R, meeting his full nutritional requirements and helping to prevent micronutrient deficiencies. 

Outcome: Week 12

  • Mr R is now in full remission of his Crohn’s disease and has completed a food reintroduction programme (elimination diet) and back to 3 meals daily
  • Surgery no longer required
  • Weight increased slightly to 68.2 kg with a BMI of 20.8 kg/m2 – aim for small weight gain

 

 

Download the complete and detailed patient case here

Patient case Crohn's disease.pdf

Download the complete and detailed patient case here

Filename
Patient case Crohn's disease.pdf
Size
1 MB
Format
pdf

 

Download the comprehensive booklet here with the four example cases mentioned above

The following four example cases illustrate how different patients undergoing surgery and/or treatment for gastrointestinal diseases may benefit from tube feeding:

  • Short-term supplemental feeding following emergency bowel surgery
  • Gastrostomy tube feeding in cystic fibrosis following lung transplantation
  • Cardiac surgery and enteral tube feeding
  • Exclusive enteral nutrition in Crohn’s disease

Patient cases GI-Surgery.pdf

What Fresubin can do for your patients.

Filename
Patient cases GI-Surgery.pdf
Size
4 MB
Format
pdf

Fresubin tube feeding in surgical and gastrointestional patients. What Fresubin can do for your patients.





References:

1) Lochs H, Dejong C, Hammarqvist F, Hébuterne X, Leon-Sanz M, Schütz T, et al. ESPEN Guidelines on Enteral Nutrition: Gastroenterology. Clin Nutr. 2006;25(2):260–274.
2) Turck D, Braegger CP, Colombo C, Declercq D, Morton A, Pancheva R, et al. ESPENESPGHAN-ECFS guidelines on nutrition care for infants, children, and adults with cystic
fibrosis. Clin Nutr. 2016;35(3):557–577.
3) Braga M, Ljungqvist O, Soeters P, Fearon K, Weimann A, Bozzetti F. ESPEN Guidelines on Parenteral Nutrition: surgery. Clin Nutr. 2009;28(4):378–386.





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