The role of the gastroenterologist in the provision of artificial nutrition support.
BACKGROUND
Nutrition support is required for the prevention or treatment of malnutrition in patients with intestinal failure and those who are unable to eat.


OBJECTIVE
To determine the demands upon gastroenterologists for nutrition support, the available resources, and compliance with the British Society of Gastroenterology (BSG) guidelines.


METHODS
A questionnaire was circulated to all 483 consultant physician members of the BSG.


RESULTS
There were 336 (70%) replies. Fifty-three per cent of respondents reported malnutrition in 20% or more of their patients. Seventy-nine per cent of consultants supervised patients on enteral feeding, and 64% supervised parenteral feeding. Feeding jejunostomy was used by 61% of Teaching Hospital (TH) consultants but only 38% of District General Hospital (DGH) consultants (P < 0.001). Twenty-seven per cent of respondents headed, or were members of, a nutrition support team (NST). Forty-five and 38% of respondents did not follow written protocols for peripheral and central parenteral nutrition, respectively. Fifty-five per cent monitored catheter complications, of whom 44% reported catheter infections in 5% or more of their patients. Weights of inpatients were obtained by 76% of DGH consultants and 91% of TH consultants (P < 0.001). Fifty-eight per cent of respondents did not arrange for nutritional screening. Ninety-six per cent of consultants could access a dietitian, 55% had access to an NST and 36% had a nutrition nurse specialist (NNS). An NNS was available to 57% of TH consultants but only 23% of DGH consultants (P < 0.001).


CONCLUSIONS
Gastroenterologists have a major role in nutrition support. Facilities are suboptimal. Observing guidelines may improve nutritional care. These findings have implications for resources and training.
Stockdale
A C
AC
Department of Digestive Diseases & Clinical Nutrition, Ninewells Hospital, Dundee, UK.
Williams
B
B
Pennington
C R
CR
D003625:Data Collection; D005762:Gastroenterology; D005767:Gastrointestinal Diseases; D006801:Humans; D009748:Nutrition Disorders; D018529:Nutritional Support; D010819:Physician's Role; D017410:Practice Guidelines as Topic