Session Three: GI Dysfunction in the Traumatic Brain Injured Patient

A patient with complex feeding issues could not gain weight or reduce the episodes of vomiting, despite trying numerous feeds, until Peptamen® Junior Advance was initiated. Thereafter, his symptoms improved and his family reported improvements in his daily quality of life. Introduction. Patient X is a 4 year old boy who is exclusively gastrostomy fed. He has been under th...

It is well known that traumatic brain injury (TBI) increases the body’s metabolic response.1,2 This increased metabolic response leads to hyperglycemia, protein wasting and an increased energy demand, thus adequate nutrition support is vital for recovery.2-4 Adequate nutrition has been a clinical challenge for decades as poor feed tolerance; due to increased gastric resi...

A child (Child M) born premature at 33 weeks and 4 days with a complex secondary diagnosis that included GORD, failure to thrive, IUGR, vitamin D resistant rickets, abnormal vocal cords and chronic lung disease. All of which resulted in the need for increased nutritional requirements. This case study discusses the different feeds that were used to manage the complex feeding ...

This case study presents a child with severe neurodisabilities and gastrointestinal disease. Many children with cerebral palsy require enteral feeding to ensure adequate nutritional intake to meet nutritional requirements for growth and development, due to aspiration risk with oral intake due to dysphagia and/or gastro-oesophageal reflux disease.1 Hirschsprung’s disea...

This case study presents a four year old child, newly diagnosed with acute lymphoblastic leukaemia (ALL), who experienced significant intolerance to feeds as a result of his intense treatment regimen, largely chemotherapy. ALL is a cancer of the blood. It is the most common cancer in children, accounting for around one third of cases. Five hundred children are diagnose...

Mitochondrial myopathy is a neuromuscular disease caused by damage to the mitochondria. These are small, energy-producing structures that work as the cell’s power plant. The cells most affected are nerve cells in the brain and muscle as they require a lot of energy. The symptoms of mitochondrial myopathy include: Muscle weakness (including respiratory muscle) or exer...

A 22 year old gentleman, diagnosed with cerebral palsy (a neurological condition that is specifically caused by problems in the part of the brain responsible for controlling muscles), was referred to the Dietetic department.1 He also had a differential diagnosis of Inflammatory Bowel Disease (IBD), which is the general term used to describe ulcerative colitis a...

This case study discusses the management of a patient with Motor Neurone Disease, who developed reflux and regurgitation on commencing gastrostomy bolus feeding. Despite the use of various enteral and oral feeds, his symptoms persisted, and he lost approximately 8% of his body weight in 9 months. After commencing Peptamen® AF, a 100% whey peptide formula with 50% of fat fr...

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