Home nasoenteric feeding for malabsorption and weight loss refractory to conventional therapy.
Two patients with malabsorption syndrome and weight loss refractory to conventional pharmacologic and dietary therapy were evaluated on a metabolic ward. Baseline studies indicated moderate to severe protein-energy malnutrition, and severe energy, fat, and nitrogen malabsorption. Metabolic balance studies on low-fat elemental formulas infused nasoenterally over 18-hour periods indicated improved retention of nitrogen, phosphorus, calcium, magnesium, and energy when compared with a solid food diet. Because this dietary modification appeared to correct their malabsorption, both patients learned to insert the nasoenteral tube themselves, and a low-calorie solid-food diet combined with nocturnal tube feedings was continued at home. During the next 9 to 12 months, both patients had increases in body weight, and in the mass of fat-free tissue, skeletal muscle, and fat. This therapeutic approach may correct life-threatening semistarvation in selected patients.
D001835:Body Weight; D003424:Crohn Disease / Q000150:complications; D004750:Enteral Nutrition / Q000379:methods*; D006801:Humans; D008286:Malabsorption Syndromes / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012646:Self Administration