The article explores the prevalence and impact of GI intolerance in oncology patients and the nutritional strategies used to manage these intolerances, with a particular focus on enteral feeding. It examines the evidence supporting the use of peptide-based enteral feeds with food derived ingredients, in improving nutrient absorption and GI tolerance.

A multi-centre, single arm study to evaluate the gastro-intestinal tolerance and compliance of a high energy adult enteral tube feed with food derived ingredients.

New Directions in Home Enteral Feeding: Are food-derived ingredients changing the landscape? Expert dietitians share their views in a recorded roundtable discussion.

The brochure gives an overview on the EAT-10 tool and its validation covering it’s use in the diagnosis, screening, and intervention of dysphagia. Eating Assessment Tool 10 (EAT-10) is a list of 10 questions that can be completed in approximately 2 minutes and helps to measure to what extent a patient may experience swallowing difficulties and risk of dysphagia.

Objective: EAT-10 helps to measure swallowing difficulties. It may be important for you to talk with your physician about treatment options for symptoms.

The weaning guide contains recipes developed with leading dietitians from across the UK to help your patients' carers prepare milk-free recipes. The weaning guide can help give them confidence, that as their child grows, family meals can be adapted to make them suitable for CMA.

The webinar was live in February 2024. The speakers discussed the Real-World Evidence for children with neuro-disabilities who have low energy expenditure coupled with feed intolerances may benefit from a low-energy hydrolysed enteral formula to minimise the risk of excessive weight gain, further compromising mobility and obesogenic complications.

The prevalence of children with complex neuro-disability has increased due to advances in the medical management of preterm infants and improved care for children with severe neurological impairment . Neuro-disability covers a wide range of clinical conditions, including acquired brain injury, epilepsy and learning disability. Neuro-disabilities present a significant disease burden for the child and family, with the focus for families to promote the best possible participation in life for all affected. Children with neuro-disabilities can be significantly disadvantaged in their ability to nourish themselves due to poor hand to mouth motor coordination, along with disordered swallowing, resulting in aspiration of food in the lungs. The length of feeding time may be considerably increased and instead of mealtimes being an enjoyable experience, they are distressing for both child and carer. These impairments in feeding eventually lead to undernutrition and invariably children require a feeding tube to ensure nutritional requirements are met. Although tube feeding improves overall nutritional status, it has also been associated with an excess deposition of body fat compared with typically developing children. Children with neuro-disability are at risk of becoming overweight because of their low activity and psychosocial constraints. Additionally, children with a neuro-disability tend to grow slowly for non-nutritional reasons and have altered body composition due to underdeveloped skeletal muscle. Children are more likely to be overweight and tend to have low lean muscle mass - therefore a low BMI in this group does not necessarily imply low fat stores. Efforts are needed to protect severely disabled children from overfeeding and to help families of children with neuro-disabilities to manage their child’s weight. Children with neuro-disabilities who are fed to 80% of their estimated average energy requirements have reported a positive energy balance resulting in high body fat mass. Of note, any attempt to dilute the existing proprietary feeds to reduce the calorie intake to a level commensurate with the energy expenditure of a child with a disability is likely to have an adverse impact on micronutrient and protein intake. The clinical nutrition industry has responded to this need and developed commercially available enteral formulas that are low in energy but nutritionally adequate for protein and micronutrients, essential for developing children who are reliant on enteral formula to supply a major proportion of their intake [8]. Additionally, feed tolerance is generally worse in children with neuro-disabilities, associated with comorbidities including epilepsy, posture and tone disorders, and medications used for the treatment of these conditions can further exacerbate gastrointestinal function. Common feed related symptoms associated with neuro-disabilities include vomiting, retching, pain associated with feeding - feedinduced dystonia, constipation, and gastrointestinal dysmotility. The aim of this national multicentre retrospective study was to monitor the effectiveness of a low energy hydrolysed enteral formula on weight management, feed tolerance and health economics in children with a neuro-disability.

GEORGE IS A 63 YEAR OLD MARRIED MAN WHO WAS DIAGNOSED WITH MALIGNANT NEOPLASM OF THE OESOPHAGUS IN SEPTEMBER 2011. A two stage oesophago-gastrectomy was performed in February 2012 with a jejunal tube inserted for feeding. The patient reported that during his hospital stay he was given a polymeric feed via the jejunostomy. He suffered with severe diarrhoea for the length of his hospital stay. He was discharged home in April 2012, taking small meals and snacks without enteral nutrition. Over a 6 mo...

This case study discusses the nutritional management of a severely undernourished patient with head and neck cancer. The patient experienced diarrhoea and significant weight loss, despite the use of various enteral formulas and delivery methods (continuous and bolus feeding). Thereafter a combination of products within the Peptamen® range were trialled. A marked reduction i...

A hub of tube feeding support and guidance for parents & carers of tube fed children. Talking Tube Feeding features informative articles written by healthcare professionals, inspiring stories shared by tube feeding families, and even blended diet recipes created by a dietitian. Share with your families today! All Talking Tube Feeding articles and videos have been created in partnership with healthcare professionals and tube feeding families, aiming to offer credible tube feeding information. Visit Now Highlights include   Andie & Ava's Story - 3 part video series 10+ Blended Diet recipes written by a paediatric dietitian Tube feeding glossary & equipment guide Transitioning to adult care Share with your patients' families today! www.talkingtubefeeding.com Contribute to Talking Tube Feeding We’re always looking for healthcare professionals to contribute their expertise to the Talking Tube Feeding website. So, if you have an interesting topic suggestion, get in touch at: talkingtubefeeding@uk.nestle.com Connecting with Families If you think your families would like to share their tube feeding experiences on Talking Tube Feeding, please contact us on: talkingtubefeeding@uk.nestle.com. We can work flexibly with families, whether they want to contribute quotes/recommendations or a full diary-style feature. To order Talking Tube Feeding pens and leaflets for your families, please contact your Nestlé Health Science representative.

The Effective management of each resident’s hydration and nutrition can prevent complications and improve quality of life for patients. Explore NHS Enhanced Care in Care Homes framework’s best practice guidance for healthcare professionals.

The needs of dysphagia patients is diverse and can vary from patient to patient. To keep patients safe, it is important that the right questions are being asked. Read the latest Care Quality Commission guidelines for guidance and support on key considerations in the management of dysphagia. 

This is a great recipe for dysphagia patients looking to enjoy a biscuit with their afternoon tea. Suitable for IDDSI levels 4,5 and 6 this recipe provides a step-by-step guide on soaking solution for biscuit.

Providing more choices for your dysphagia patients can help encourage patients to drink and may improve hydration. This IDDSI 3 level smoothie recipe is a great option for patients looking for a fruity drink or a refreshing summer beverage.

Dr Graeme O’Connor from Great Ormond Street Hospital, London, UK explores the use of blended tube feeds in detail, covering microbiomes and dysbiosis, tolerance and the role of short chain fatty acids, while sharing his own clinical experience of using feeds containing food-derived ingredients.

Published in HSOA Journal of Neonatology and Clinical PediatricsThis case study series provides an overview of four children aged between twenty-six months to ten years. The children have a range of conditions including learning and physical disabilities, digestive tract abnormalities and genetic conditions such as DiGeorge’s syndrome. Reflux, constipation and vomiting were among the symptoms of feed intolerance reported.  Significant improvements in these symptoms were reported following a change to Compleat Paediatric®; a 1.2 kcal/ ml formula with 14% food derived ingredients (Nestlé Health Science), which resulted in improved quality of life for children and their families. Compleat Paediatric® could be considered as a sole source of nutrition or in conjunction with BD when children are not tolerating a standard commercial formula.Case studies provided by;Aneeqa Siddiqui, Paediatric Dietitian, Birmingham Women’s and Children’s NHS FoundationTrust, Birmingham, UKVictoria Steele, Senior Specialist Dietitian, Friarage Hospital, Northallerton, UKMarti van der Linde, Community Paediatric Dietitian, Worcestershire North, Nutrition and Dietetic teamOrder Samples

Watch our webinars here: Emerging Trends in Blended Diets 1 Year on – Evidence & Clinical Practice The third webinar in the series has four experienced clinicians talk about their experiences of transitioning paediatric patients to a blended diet, as well as, a tube feeding formula with food-derived ingredients. Our speakers dive into the anatomy of why providing a blended diet may be better tolerated than a standard tube feed, as well as the process and multi-disciplinary team approach in creating and implementing a blended diet policy. Followed by an engaging Q&A with the audience. Speakers; Kate Samela, Dr Mohamed Mutalib, Marie Watson and Naheeda Habib   A Practical Implementation of Blended Diets for Healthcare Professionals The second webinar in the series, focuses specifically on the practical challenges that Healthcare Professionals face in supporting parents, carers and families through their journey in using blended diets as a source of nutrition for their child. Our speakers discuss feeding tubes, risk assessments and how they have successfully introduced blended diets to their patients. Speakers; Dr Su Bunn, Denise Kennedy, Vicki Steele and Clare Armstrong   The Emerging Trend of Blended Diets; Sharing Best Practice Amongst Healthcare Professionals Our first webinar dives into the emerging trend of blended diets for enteral feeding. Our speakers discuss how blended diets may change the way we think about tube feeding and compare with the USA, who are leading the way when it comes to blended diets and food-based formulas. We hear about the positive move made by the British Dietetic Association in their updated guidance on blended diets and hear about the growing evidence for a newly available prescribed feed that contains food-derived ingredients. Speakers; Gerard Minor, Dr Clare Thornton-Wood, Jayne Lewis      

The successful introduction of Resource® ThickenUp™ Clear took place across the Leeds Teaching Hospitals NHS Trust (LTHT) in January 2016. This includes: Leeds General Infirmary St James’s University Hospital Chapel Allerton Hospital The speech and language therapy LTHT outpatient service Why switch thickener? The switch from the previous starch-based thickener was ...

N. Vilardell1, L. Rofes2, V. Arreola1, R. Speyer3,4, P. Clave´1,2,3,5 Received: 16 December 2014 / Accepted: 11 November 2015 / Published online: 25 November 2015 © Springer Science+Business Media New York 2015 N. Vilardell natalia.vilardell@hotmail.com 1 Unitat d’Exploracions Funcionals Digestives, Department of Surgery, Hospital de Mataro´, Universitat Auto`no...

Purpose Diet modification is an established first-line compensatory technique for dysphagia management, and thickeners are used to modify liquids. Commercial thickening agents are used to decrease the flow rate of liquids, and allow patients more time to initiate the swallow. Patients do not always like thickened fluids and so compliance can be difficult to achieve. We unde...

For people with dysphagia, it is commonly recommended for fluids to be thickened in order to assist with bolus control and help reduce the risk of choking and aspiration.1-4 However, it has been found that many patients report a dislike of thickened fluids, especially thicker consistencies, thus reducing their quality of life and increasing their risk of dehydration from..

Bolus manipulation is a primary treatment strategy in the management of oral-pharyngeal dysphagia. The use of thickening agents to alter bolus rheology is particu-larly commonplace; however, the precise effects of these alterations on swallowing remain uncertain. The purpose of our study, a prospective, double-blind clinical trial (Level 1b), was to investigate the effects o...

S. Popa Nita •  M. Murith •  H. Chisholm • J. Engmann •  Received: 5 March 2012 / Accepted: 10 December 2012 / Published online: 14 February 2013 The Author(s) 2013. This article is published with open access at Springerlink.com S. Popa Nita M. Murith H. Chisholm J. Engmann (&) Nestle´ Research Center, Nestec Ltd, Vers-chez-les-Blanc, PO Box 44, 1000 Lausanne 26,..

NESTLÉ HEALTH SCIENCE 2016 Aim To undertake a trial to compare Resource® ThickenUp™ Clear against their current starch based thickener and address the current difficulties. Method Nestlé Health Science provided samples of Resource® ThickenUp™ Clear to the Stroke Unit to trial this thickener The trial consisted of numerous evaluation components: Taste test – included staff and patients with dysphagia ...

Eat10 – A quick and easy screening tool, validated to identify those at risk of Dysphagia.

Resource ThickenUp Clear Clinical Evidence

The symptom diary is for a carer of an infant suffering from signs and symptoms that could be linked to Cow's Milk Allergy (CMA) or other food allergies. Help your patients carer prepare for their next health visit, learn about common symptoms, which will help inform you to make a correct diagnosis.

NESTLÉ HEALTH SCIENCE 2015 Aim To collect user feedback and fluid intakes of residents on a thickening powder for management of dysphagia to support a possible change from their current starch based thickener to Resource® ThickenUp™ Clear in Four Seasons care homes in Northern Ireland. Method 2 week fluid intake chart data collection whilst on current thickener across 2 sites Nestlé Health Science deliver...

L. Rofes*, V. Arreola†, R. Mukherjee‡, J. Swanson§ & P. Clave*,† *Centro de Investigacion Biomedica en Red de enfermedades hepaticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain. †Unitat de Proves Funcionals Digestives, Department de Cirurgia, Hospital de Mataro, Universitat Autonoma de Barcelona, Mataro, Spain. ‡Nestle Research Center, Nestec Ltd, L...

Rofes L, Arreola V, Mukherjee R, Clavé P Neurogastroenterol Motil 2014 Sep;26:1256-65. Aim: To re-validate the accuracy of the Volume-Viscosity Swallow Test (V-VST) for Clinical Assessment by using a new thickening agent with an exclusive formula (ThickenUp® Clear) on 120 patients with oropharyngeal dysphagia associated with age and neurological pathology. Results: The study sh...

Herentry K, et al. European Geriatric Medicine. 2011;2(S24-S206.). Excellent Compliance1: Does not affect colour, taste and odour of hot or cold liquids or foods. Flavourless & Odourless No lumps in various liquids Practically transparent in water 98% of professionals state that it helps improve compliance* Easy to Prepare6 The results obtained with Resource® ThickenUp® Cle...

Introduction Prescribed thickeners are used to thicken fluids to a more viscose consistency than normal, because drinking thicker fluids has long been thought to reduce the risk of aspiration for people with dysphagia. A recent systematic review has identified that thickening liquids can reduce risk of aspiration.1 Many older people live with dysphagia, and a recent review study2 fou...

Hear from independent Speech and Language Therapist, Sandra Robinson, on the role of thickeners, such as Resource® ThickenUp® Clear, when it comes to supporting those with dysphagia.

Hear from independent Speech and Language Therapist, Sandra Robinson, on the role of thickeners, such as Resource® ThickenUp® Clear, when it comes to supporting those with dysphagia.

THE DIETARY MANAGEMENT OF A COMPLEX COWS’ MILK ALLERGY PATIENT USING ALFAMINO® A 2 month old baby was referred for Nasogastric feeding following an episode of bronchiolitis. The baby had a past medical history of atopic eczema and was previously managed by the GP and Allergy & Dermatology team. Patient’s background, medical history, physical diagnosis The patient was born full term in August 2014. Pre-October 2014, there was one admission to hospital fo...

A practical approach to managing a CMA infant with Althera™ Cows’ Milk Allergy (CMA) can occur in 1.8% - 7.5% of infants in the first year of life.1 The allergy is defined as an adverse reaction to the proteins in milk with most children growing out of their allergy by the time they reach one year. The treatment consists of the exclusion of cows’ milk from the infant’s diet. There...

Cows’ milk allergy (CMA) is one of the major food allergies during infancy and childhood. Hypoallergenic formulas can be necessary for managing infants and children with severe CMA. According to the American Academy of Pediatrics (AAP), a formula is “hypoallergenic” if it does not provoke allergenic activity in 90% of infants or children with confirmed CMA with 95% confid...

" MANAGING COWS’ MILK PROTEIN ALLERGY WITH ALFAMINO® Overview of cows’ milk protein allergy in infants Cows’ milk protein allergy (CMPA) is one of the most common food allergies in infants.1 Symptoms of CMPA include :  Gastrointestinal (32-60% cases) Skin (5-90%) Anaphylaxis (0.8-9%) Respiratory Many of these symptoms overlap. CMPA can be classified into two groups: IgE mediated or non-IgE mediated (delayed hypersensitiv..."

" THE USE OF AMINO ACID FORMULA IN THE DIETARY MANAGEMENT OF SEVERE INFANT COWS’ MILK ALLERGY Approximately 2-7.5% of infants have symptoms of CMA1 whilst symptoms suggestive of Cows’ Milk Allergy (CMA) may be encountered in up to 15% of infants,  emphasising the importance of controlled elimination/milk challenge procedures2. The diagnosis and treatment pathways for cases of CMA are well documented and several guidelines exist to support the healthcare professional in..."

Cows’ milk protein allergy (CMPA) is the leading cause of allergy in infants. Previous studies assessing milk formulas with extensively hydrolyzed proteins have reported issues such as reactivity to residual allergens, bitter taste, and the impracticability of adding lactose.

During the last decade, the prevalence of allergic diseases in infants and children has increased significantly either through better awareness of the symptoms or through generally more children being affected.1-3 Therefore, it is no surprise that the numbers of children presenting to clinics in district general hospitals has also increased.4-5 Diagnosis of true milk allergy is key...

Differentiating milk allergy (IgE and non-IgE from lactose intolerance: understanding the underlying mechanisms and presentations.

There is much confusion between the diagnostic terms ‘lactose intolerance’ and ‘cows’ milk allergy’, which are often used interchangeably, resulting in the potentially incorrect clinical management of these two distinct conditions.

To characterize the peptide profile of a whey-based, extensively hydrolysed formula (eHF) prepared with a non porcine enzyme blend, and to assess whether it meets the hypoallergenicity criteria of the Ame...

The aim of the symposium was to share learnings from the recently established European Academy of Allergy and Clinical Immunology (EAACI) Task Force on special products for cow’s milk protein allergy (CMPA), with the intention of providing an overview on controversies regarding extensively hydrolysed formulas (eHFs), their utility, and the validity of the definition ‘special products ...

This symposium took place during the 2018 meeting of the European Academy of Allergy and Clinical Immunology (EAACI). Focussing on the fundamental issues of suboptimal management of patients with cow’s milk protein allergy (CMPA), the speakers discussed key themes for optimising management.

To assess if an amino acid-based formula supports normal growth in infants with cow's milk protein allergy (CMPA).

The CoMiSS score was developed as an easy-to-use awareness tool for primary health care providers to increase the awareness of the most common symptoms of cow's milk protein allergy (CMPA) and the evolution of symptoms during a therapeutic intervention. The purpose of the study was to evaluate the score in infants with symptoms indicative of CMPA and to evaluate...

To determine whether an extensively hydrolyzed formula (EHF) supplemented with two human milk oligosaccharides (HMO) was tolerated by infants with cow’s milk protein allergy (CMPA). Methods: A whey-based EHF (Test formula) containing 2′fucosyl-lactose (2′FL) and lacto-N-neotetraose (LNnT) was assessed for clinical hypoallergenicity and safety. The Control formula was...

Prof O’Mahony began by discussing how the human gut is colonised by a wide diversity of microbes. He went on to review the evidence for how they exhibit highly evolved synergistic relationships to provide essential biological functions to the host and how the gut microbiome is influenced by many factors in early life. Prof Renz proceeded to describe the importance of establishing a s..

16 weeks old, female twins were identified on EMIS search at a GP practise by an Oviva community dietitian for review. They were not already under the care of a dietitian and had both been started on Neocate LCP® for suspected cows’ milk allergy (CMA) at 6 weeks old by a paediatrician. The dietitian successfully switched both twins to SMA Alfamino and later stepped them down to SMA Althera.

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...

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...

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...

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...

THE PEPTAMEN® FAMILY IS SUPPORTED BY OVER 50 PUBLICATIONS. WE HAVE SELECTED FOUR KEY SUPPORTING EVIDENTIAL PIECES, SPECIFICALLY FOR PAEDIATRICS TO SHARE WITH YOU IN DETAIL, AS WELL AS HIGHLIGHTS FROM OUR RANGE OF CLINICAL EVIDENCE.

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...

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...

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...

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 ...

Crohn’s disease (CD) is a chronic inflammatory bowel disease characterised by patchy, transmural inflammation and ulceration affecting anywhere in the gastrointestinal tract with ileocolonic disease being the most frequent presentation.1 While the exact cause of CD is not known, it is thought to result from a complex interplay between intestinal bacteria and environmenta...

Crohn’s disease (CD) is a chronic inflammatory bowel disease characterised by patchy, transmural inflammation and ulceration affecting anywhere in the gastrointestinal tract with ileocolonic disease being the most frequent presentation.1 While the exact cause of CD is not known, it is thought to result from a complex interplay between intestinal bacteria and environmenta...

This following shows a non-extensive list of the key clinical evidence behind Modulen® IBD. You will find a chronological summary of all the data collected and published over recent years that demonstrate the safety and efficacy of this product in Crohn’s Disease. Modulen® IBD is the only enteral product with extensive clinical evidence in Crohn’s Disease. All these studies have great...

The Optifast welcome pack gives you all the information you need about our Optifast products as well as usage instructions and a step by step guide on how to place an order. The Optifast range provides a selection of tasty products that have been developed specifically for medically-supervised weight loss. Why Optifast? - Nutritionally Complete & Balanced - Medically endorsed - Clinically Proven - Hassle free product ordering

Recently, as reported by dietetic departments in the United Kingdom, we have seen an increase in Homemade Blended Diets (HBD) being given to children requiring tube feeding. HBD practice may increase the risk of tube occlusion and nutritional inadequacies. In 2015 the British Dietetic Association (BDA) developed their first ‘Practice toolkit liquidised food via gastrostomy tube’, whic...

The Nestlé Health Science dysphagia team have proudly partnered with independent Speech and Language Therapist Sandra Robinson and Research Outreach to create an informative article: Thickeners, the evidence for their appropriate use in dysphagia management. The research article explores the different ways in which dysphagia can affect an individual’s quality of life through physica...

The Clinical Nutrition Highlights newsletters will provide a structured compilation of the most relevant nutritional clinical guidelines and recently published articles on how to manage nutritional issues related to COVID-19. The objectives are to: Help identify the key recommendations among the large amounts of data generated on COVID-19. To provide HCPs with an easy read ...

This checklist can be used when transitioning a child onto a blended diet, using Compleat® paediatric as a base in recipes. Use this resource as a blended diet risk assessment and agreement between parents/carers and dietitian.

Critical illness is often associated with catabolism. Consequently, providing nutritional support to those who cannot eat is essential to prevent malnutrition in the critical care setting.1 When considering nutrition support in the critical care unit (ICU), certain comorbidities should be taken into careful consideration when formulating an enteral feeding plan. For exa...

Many patients requiring long term enteral nutrition have neurological disorders, such as motor neurone disease (MND) or Huntington’s disease (HD). In our experience, a proportion of these individuals may struggle to tolerate enteral feeding despite optimising medical management and excluding obvious gastrointestinal pathology. In MND, prolonged reduced mobility, weaknes...

This case study discusses the nutritional management of a severely undernourished patient with head and neck cancer. The patient experienced diarrhoea and significant weight loss, despite the use of various enteral formulas and delivery methods (continuous and bolus feeding). Thereafter a combination of products within the Peptamen® range were trialled. A marked reduction i...

Major trauma refers to significant or multiple injuries that could result in death or severe disability, sustained from a traumatic insult such as a road traffic collision, fall, sporting accident, or physical assault. It is the leading cause of death and major disability in people aged under 45 years in the UK.1 Critically injured patients are often managed on ...

GEORGE IS A 63 YEAR OLD MARRIED MAN WHO WAS DIAGNOSED WITH MALIGNANT NEOPLASM OF THE OESOPHAGUS IN SEPTEMBER 2011. A two stage oesophago-gastrectomy was performed in February 2012 with a jejunal tube inserted for feeding. The patient reported that during his hospital stay he was given a polymeric feed via the jejunostomy. He suffered with severe diarrhoea for the length of his hospital stay. He was discharged home in April 2012, taking small meals and snacks without enteral nutrition. Over a 6 mo...

Introduction/overview Chronic pancreatitis is a progressive and irreversible inflammatory disease of the pancreas. This results in exocrine and endocrine dysfunction which in time leads to maldigestion and malabsorption reducing the body’s ability to utilise essential macro and micronutrients. Consequently protein energy malnutrition is common. Research indicates that in more than 80...

This case study discusses the nutritional management of a critically ill patient with a traumatic brain injury (TBI). Due to poor tolerance of gastric feeding, his nutritional requirements could not be met using a polymeric formula. His feed was changed to Peptamen® HN (a 100% whey peptide feed) and enteral absorption improved, allowing his full nutritional requirements to b...

Human immunodeficiency virus (HIV) is a virus that attacks the immune system specifically targeting CD4 cells, white blood cells which play a major role in protecting against infection. As the virus progresses and the CD4 count decreases there is an increased risk of certain infections referred to as ‘opportunistic infections’ (OIs). The gastrointestinal (GI) tr...

"ENTERAL TUBE FORMULA: A MULTICENTRE TRIAL IN THE UNITED KINGDOM The prevalence of Cerebral Palsy (CP) children who require a low-calorie feed is between 8-15%. ESPGHAN working group recommend using a low-fat, low-calorie, high fibre, micronutrient replete formula for immobile Neurological Impaired children. Children aged 1-11 years with neurological issues were recruited from UK National Health Service (NHS). Participants were given the new low-c..."