Background Information

Arnold is an 82 year old male patient with a ruptured oesphagus and dysphagia. He is nil by mouth and reliant on tube feeding via a percutaneous endoscopic gastrostomy tube with a jejunal extension (PEG-J).  His regular prescription for medication includes Ranitidine, Domperodone, Citalopram, Hyoscine patches, Carbocisteine, Lansoprazole, Zopiclone and Cyclizine. He lives at home and was experiencing loose stools up to 5 times a day with an urgency to pass stools. 

Nutritional Treatment Goals

• Meet nutritional requirements

• Reduce diarrhoea and urgenct to pass stools

Nutritional Treatment

Arnold's feed was changed from a whole protein polymeric tube feed to Vital 1.5kcal. He was prescribed 1000 ml Vital 1.5kcal, which was fed continuously over 17 hours via his PEG-J

Key Findings

1. Frequency of stools and severity and frequency of urgency to pass stools showed improvement 5 days after changing his feed to Vital 1.5kcal. 

2. Better tolerance has allowed for a longer rest period between feeds and an improved quality of life (QoL).

Conclusion

Vital 1.5kcal supported feed tolerance, with reduced frequency and severity of loose stools, as well as reduced urgency to pass stools in an 82 year old man with a ruptured oesophagus, dysphagia and PEG-J in the community, leading to an improvement in his QoL. 

Dietian, East Berkshire

UK-VIT1-5-2200008 | June 2022