title: Gastrointestinal side effects and adequacy of enteral intake in hematopoietic stem cell transplant patients.
abstract: BACKGROUND
  Patients undergoing hematopoietic stem cell transplant (HSCT) can experience gastrointestinal (GI) side effects as a complication of the treatment. Limited research exists describing how the duration and severity of GI side effects influence the consumption of adequate calorie intake in this population. The purpose of this study was to assess differences in GI side effects between patients who consumed adequate calories compared with those who did not.
  
  
  METHODS
  The MD Anderson Symptom Inventory-Gastrointestinal (MDASI-GI) tool was used to record daily GI side effects of 72 HSCT patients. Daily calorie intake was determined via calorie counts. Data were collected from day of transplant until engraftment.
  
  
  RESULTS
  Median percentage of caloric needs consumed for all patients was 49.2% (interquartile range, 35.1-66.6). Calorie intake decreased from baseline to transplant day 8 as severity of GI symptoms increased. An inverse relationship between percentage of caloric needs met and MDASI-GI component score, MDASI-GI symptom score, and lack of appetite score was observed. The only significant difference in MDASI-GI symptom scores between those who consumed adequate calories and those who consumed inadequate calories was for diarrhea; subjects who consumed >60% of caloric needs had significantly lower median diarrhea scores.
  
  
  CONCLUSIONS
  Most patients consumed <60% of their caloric needs from time of transplant to time of engraftment. More research is needed to provide insight into strategies to increase intake and to describe the implications of prolonged inadequate intake in HSCT patients.
authors.affiliation: Eskenazi Health, Indianapolis, Indiana maeganwalrath@gmail.com.
authors.forename: Maegan
authors.initials: M
authors.lastname: Walrath
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Bacon
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Sharon
authors.initials: S
authors.lastname: Foley
authors.affiliation: Fox Chase Cancer Center-Temple Health, Philadelphia, Pennsylvania.
authors.forename: Henry C
authors.initials: HC
authors.lastname: Fung
mesh_terms: D000328:Adult; D000368:Aged; D001066:Appetite; D003967:Diarrhea / Q000209:etiology; D002149:Energy Intake; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: adverse effects; enteral nutrition; nutrition therapy; nutritional support; stem cell transplantation