Useful tips regarding nutrition / diet
1. Oral nutrition
- High-calorie (50-60 kcal / kg / d), liquid-rich, nutrient-rich and low-fiber diet
Goal: easily digestible food, light balanced diet - Limitation of long-chain fats and replacing them with medium-chain fats (up to 50% of energy intake.); Adequate supply of essential fatty acids
- Protein content about 20% of energy intake (1.5 – 2.0 g / kg / d), milk protein (calcium!) desirable (yoghurt, quark, low fat cheese)
- Wholemeal bread and soft vegetables, initially beginning with freshly squeezed vegetable juices; if this is conventionally impossible, it should be supplemented by nutrient-defined or chemically defined formula diets (as nutritional drinks or by feeding tube)
- Initial addition of vitamins (after extensive removal): 100 mg orally on a daily basis
- Frequent (6-9) smaller meals and, initially, only drinking between meals, alcohol abstinence
- Recommendable as long-term diet if oral food intake is not sufficient anymore
- Pump-controlled (mostly during the night) feeding, adapted to the patient?s metabolism, initially diluted, nutrient-defined formula diet. Oligopeptide diet (with > 75% loss of the small intestine)
- Calculating the energy content, the nutrient composition and the drug-based nutrient supply based on the same principles as with the oral diet
- Recommendable as long-term diet with severely shortened remaining bowel (not always with less than 60 cm), if the dietary condition has not improved or stabilzed through tube feeding
- In addition to parenteral nutrition, oral or enteral feeding (where practicable) should always be tried to support the recovery and functional adaptation of the remaining intestine (“absorption training”)
Consideration of individual needs and intolerances
2. Tube feeding via the gastro-intestinal tract (enteral)
3. Nutrition while bypassing the gastrointestinal tract (parenteral)
With each type of food intake, body weight, plasma proteins, serum electrolytes, the liquid, vitamin and trace element levels as well as stool volume and the amount of urine must be monitored and controlled regularly!
