Therapeutic Nutrition
What is Therapeutic Nutrition?
Therapeutic nutrition is the provision of nutrients to maintain and/ or restore optimal nutrition and health. Therapeutic diets may be required as therapy for a disease e.g. coeliac disease or to treat malnutrition arising from low energy and nutrient intakes or due to increased energy and nutrient needs.
Where is it Applied
A therapeutic diet may be provided orally (through eating/ drinking), enterally (through a tube directly into the gastrointestinal tract) or parenterally through the veins of the circulatory system.
Oral nutrition
Oral nutrition is interpreted as food or other nutrients taken by mouth. Oral nutrition support is the first step for who are suffering from weight loss or are unable to eat and drink enough to meet their energy and nutrient requirements. It is provided for people who are able to swallow safely and have a functioning digestive system. The overall aim of oral nutrition support is to provide a balanced diet with enough protein, fluid and macronutrients to meet the patient’s nutritional needs and help improve clinical outcomes.
Oral nutrition support must respond to the specific needs of an individual. For example, people suffering from nausea and vomiting, swallowing difficulties, weight loss or reduced appetite will each require different forms of oral nutrition support. We shall now look a each of these problems in greater detail.
Nausea and vomiting
Nausea and vomiting are symptoms of an underlying disease and not a specific illness. Nausea is the sensation that the stomach wants to empty itself, while vomiting (also called emesis), is the act of forcible emptying of the stomach. There are many causes of nausea and vomiting. For example, the symptoms may result from medications and medical treatments e.g. chemotherapy, pregnancy, mechanical obstruction of the bowel and acute gastritis which can include good poisoning, gastric flu and infections.
It is important that people are aware of what is causing their nausea and vomiting and it is important for them to get medical advice especially if symptoms persist or are associated with pain, fever or vomiting blood.
Where patients have experienced vomiting it is important to give the stomach time to rest while still avoiding dehydration. Clear fluids should be attempted for the first 24 hours of an illness, and then the diet should be advanced as tolerated. Clear fluids are easy for the stomach to absorb and include water, sports drinks, jelly, ice lolly's and clear soups
When solid foods are tolerated nausea may be helped by: Eating small meals and snacks throughout the day and avoiding eating large meals. Not eating fried foods, spicy foods or foods with strong odors. Choosing plain foods such as toast, crackers, salty snacks and ginger flavored drinks and foods. Prescribable medications can also help control the nausea or vomiting.
Swallowing problems
Chewing and swallowing problems (also called dysphagia) can result from disabilities such as stroke, cerebral palsy, Parkinson's disease, muscular dystrophy, multiple sclerosis and dementia. The cause of swallowing difficulties must always be investigated by a doctor. If food and liquids cannot be swallowed safely it may be aspirated or drawn into the lungs. As the airways become blocked, the person will begin to choke and this choking fit may be fatal for frail, elderly people. The aspiration of food and fluid into the lungs can also cause aspiration pneumonia.
Once the cause of swallowing difficulties has been investigated, people may be advised to follow a specific diet. Examples include a minced diet where all food is minced for easier chewing or swallowing and a pureed diet, where a blender or food processor to puree foods to the consistency of baby food, while soft and smooth foods, such as applesauce, puddings and eggs can be served in their normal form. Thickened fluids may be recommended as a remedy to chewing and swallowing problems. Artificial food thickeners are available from the pharmacy while natural thickeners include tapioca, flour and instant potato flakes.
Weight loss and reduced appetite
Unintentional weight loss is a decrease in body weight that is not voluntary. In other words, you did not try to loss the weight by dieting or exercising. There are many causes of unintentional weight loss. Examples include, cancer, depression, drugs such as chemotherapy drugs, Eating disorders, loss of appetite and malnutrition. Painful mouth ulcers or a loss of teeth may also prevent someone eating normally and result in weight loss. Weight loss and poor oral intake can have a serious impact on a person’s clinical outcome following a surgical procedure. Causing reduced immune function, poor wound healing and thus, longer hospital stays.
