Article Text
PDF
Statistics from Altmetric.com
Jejunal feeding: when is it the right thing to do?
This is a complex topic – straightforward if there is a structural problem which precludes oral or intra gastric feeding, but more complicated in patients with no clear structural abnormality. Paine and colleagues review the issues – what is the goal of therapy, is the patient malnourished, the different causes, the practicalities, the need for an exit strategy and ‘what next’ if jejunal feeding fails. The evidence base for relief of functional symptoms (nausea and vomiting, early satiety, the feeling of fullness and pain) in the absence of a physical cause is limited. The authors discuss the multiple differential diagnosis including rumination syndrome, cyclical vomiting disorder, cannabinoid hyperemesis syndrome, functional dyspepsia, pseudo-obstructive disorders, multisystem disorders (including neurological), disordered eating and food intolerance . There is a strong emphasis on a cohesive and rehabilitative focused multidisciplinary approach to improve outcomes avoiding jejunal feeding where possible. The authors discuss the concept of “effortful oral feeding as the least worst option” in the face of ongoing symptoms, in the absence of malnutrition, sometimes being the safest and most appropriate approach compared with the risks and complications associated with jejunal feeding ( See page 397).
Multi-professional in situ simulation is an effective method of identifying latent patient safety threats on the gastroenterology ward
In situ simulation (ISS) is an …
Linked Articles
- Small bowel and Nutrition
- Education
- Liver
- Liver
- Colorectal
- Small bowel and Nutrition
- Commentary