Gastro-Intestinal

THERAPEUTIC FIELDS

GASTRO-INTESTINAL

Feeding patients who are malnourished or at risk of malnutrition, whether by oral or enteral routes, can be a challenge since not all formulas are well tolerated. This can result in elevated gastric residuals, vomiting, diarrhoea, malab-sorption and/or abdominal pain.


The side effects resulting from GI intolerance have an impact on patient care.

GI INTOLERANCE CAN AFFECT PATIENT OUTCOMES

GI intolerance is a state in which one or more of the GI tract’s functions (digestion, absorption, motility, and barrier) is affected. Therefore, GI intolerance is a complex problem which presents itself as diarrhoea, vomiting and high gastric residuals.8

GI intolerance can lead to poor clinical outcomes, potentially increasing care costs, due to the utilisation of more expensive therapies and extended lengths of stay in ICU.

ENTERAL NUTRITION AND USING THE GUT CAN HELP IMPROVE GI TOLERANCE

It is important to use the patient's gut if it works. Enteral nutrition (EN) is preferred over parenteral nutrition (PN) because it helps to maintain normal intestinal structure and function.

ENTERAL NUTRITION IS PREFERRED FOR THE GUT

The following image shows intestinal mucosa in the ‘fed’ state. EN delivers nutrients and attracts blood flow to the gut; this stimulates the growth of the intestinal mucosal cells and maintains gut integrity. Gut integrity prevents bacterial translocation (when bacteria move from the GI tract into the bloodstream because the mucosal barrier is not functional or is weak), and reduces the risk of sepsis.


The bottom image shows the consequences of not using the gut. The intestinal villi have atrophied and their surface area for digestion and absorption is reduced. The junctions in the mucosal barrier have become less ‘tight’ and bacteria can pass through them, i.e. translocate through the gut wall.8,9