title: Muscle cramps are the commonest side effect of home parenteral nutrition.
abstract: OBJECTIVE
  Complications resulting from home parenteral nutrition (HPN) reduce a patient's quality of life. The major complications of catheter-related sepsis, venous thrombosis and chronic liver disease are well recognised. This study aimed to determine if there were other minor, but common complications that caused patient distress.
  
  
  METHODS
  All patients (45) from four HPN centres were asked if they had suffered any side effects of parenteral nutrition and whether these side effects related to the timings of the feed or required specific intervention.
  
  
  RESULTS
  Muscle cramps were the most common minor side effect [12/45 (27%)]. A greater proportion of HPN patients (51%) suffered from muscle cramps than did a control group of patients with inflammatory bowel disease (24%) [p=0.0001]. In the HPN patients, no significant difference in serum electrolyte concentration or in feed composition was noted between those patients with and those without cramps in relation to feeds. Cramps were of sufficient severity to warrant pharmacological intervention in 9 of 12 patients who had cramps in relation to feeds, and parenteral nutrition administration was slowed in 2 of the 12.
  
  
  CONCLUSIONS
  Muscle cramps have a high prevalence in patients receiving home parenteral nutrition.
authors.affiliation: Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK. david.elphick@sth.nhs.uk
authors.forename: D A
authors.initials: DA
authors.lastname: Elphick
authors.forename: M
authors.initials: M
authors.lastname: Baker
authors.forename: J P
authors.initials: JP
authors.lastname: Baxter
authors.forename: J M D
authors.initials: JM
authors.lastname: Nightingale
authors.forename: T
authors.initials: T
authors.lastname: Bowling
authors.forename: K B
authors.initials: KB
authors.lastname: Page
authors.forename: M E
authors.initials: ME
authors.lastname: McAlindon
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009120:Muscle Cramp / Q000453:epidemiology* / Q000209:etiology*; D016331:Parenteral Nutrition, Home / Q000009:adverse effects*; D015995:Prevalence; D011788:Quality of Life; D014882:Water-Electrolyte Balance / Q000502:physiology; D055815:Young Adult