Nutritional support

Nutritional support is a set of active measures to maintain an adequate intake of energy, nutrients, trace elements and vitamins.

Algorithm for administration of nutritional support

 * 1) With good GIT function, enteral nutrition is given (sipping, nasogastric or nasojejunal tubes) ;
 * 2) * if enteral nutrition is required for longer than 4–6 weeks, nutrition is introduced into the stoma (PEG) in bolus, intermittent or continuous form.
 * 3) In case of poor GIT function, parenteral nutrition (total, supplementary) is given;
 * 4) * short-term (up to 10 days) – peripheral application;
 * 5) * long-term (over 10 days) – by central catheter.
 * 6) Methods of administration:
 * 7) * all-in-one;
 * 8) * multiple bottles.
 * 9) Components of enteral nutrition:
 * 10) * carbohydrates - the basis is glucose (150 g/day);
 * 11) * fat emulsions – 1–2 g/kg/day;
 * 12) * essential AMC – Val, Leu, Ile, Phe, Try, Lys, Met, Thr.
 * 13) Contraindications of enteral nutrition:
 * 14) * sudden abdominal events (ileus conditions), toxic megacolon, severe abdominal infections, bleeding into the GIT;
 * 15) * when applying fat emulsions there is a risk of hyperlipoproteinemia, fat embolism , shock , sepsis, DIC.

Dietetics
Diet therapy means adjusting the diet in order to influence the disease process, the so-called sparing diet:


 * mechanical examination – must not increase tone or peristalsis;
 * chemical investigation – its composition must not irritate the mucous membrane and increase secretion;
 * thermal protection - must not irritate the digestive tract thermally.

Classification of diets

 * 1) strict sparing diet – in an acute state, incomplete;
 * 2) basic sparing diet – full of energy and biological value, served long-term;
 * 3) sparing diet:
 * 4) * special - tea, liquid nutritional, with strict fat restriction, diabetic;
 * 5) * basic – liquid, mushy, sparing, with fat restriction, no residue;
 * 6) * standardized – for pancreatitis, lactose intolerance, gluten, liver insufficiency.

Dietary fiber

 * A polysaccharide that has almost no nutritional value.
 * Intake should be 25-30 g per day (intake above 50 g may cause intestinal obstruction).
 * Diet with fiber content is indicated for all people who do not need to spare the digestive tract, it has a preventive effect against constipation, hemorrhoids, diverticulosis.
 * Soft (soluble) fiber - fruits, vegetables, nuts, legumes - hemicellulose, agar, pectins, mucus - absorbs excess water from the intestines, swells, binds toxic substances, increases the volume of stool and softens it.
 * Coarse (insoluble) fiber - cereals, woody plants - cellulose, lignin - increases the volume of intestinal contents, adjusts peristalsis, acts against constipation.

Related articles

 * Parenteral Nutrition (Paediatrics)
 * Biochemical evaluation of nutrition
 * Assessment of nutritional status
 * Nutrition recommendations