Abstract
Oncology treatment-related diarrhea and malnutrition appear together in oncological patients because of the disease itself, or the treatments that are administered for it. Therefore it is essential to carry out a nutritional treatment. Enteral nutrition formulas, containing peptides and medium chain triglycerides, can facilitate absorption in cases of malabsorption. There are few references to the use of enteral nutrition in the clinical society guidelines of patient management with oncology treatment-related diarrhea (OTRD). A bibliographic review of the studies with oligomeric enteral nutrition in OTRD found only nine studies with chemotherapy (all with the same oligomeric formula in which oral mucositis improves, while the rest of the outcomes show different results), and eight studies with radiotherapy (with different products and very heterogeneous results). We hereby present our action algorithm to supplement the diet of OTRD patients with an oligomeric enteral nutrition formula. The first step is the nutritional assessment, followed by the assessment of the functional capacity of the patient’s intestine. With these two aspects evaluated, the therapeutic possibilities available vary in degrees of complexity: These will range from the usual dietary recommendations, to supplementation with oral oligomeric enteral nutrition, along with complete enteral nutrition with oligomeric formula, and up to potentially total parenteral nutrition.
Highlights
In the recent years there have been substantial advances in molecularly-targeted therapies for the treatment of patients with cancer
Chemo-radiotherapy causes and even exacerbates a symptom that worsens the nutritional status of our patients, which symptom is caused by digestive toxicity, such as nausea, vomiting, mucositis and diarrhea
There are few references to the use of enteral nutrition in the algorithms of patient management with oncology treatment-related diarrhea (OTRD). This articles objective of introducing our algorithm is organized into three parts: Firstly, we review of the main clinical practice guidelines for the treatment of OTRD nutritional recommendations to assess the role that is attributed to enteral nutrition in their algorithms
Summary
In the recent years there have been substantial advances in molecularly-targeted therapies for the treatment of patients with cancer. Among the most frequent OTRD complications are: Dehydration, electrolyte loss, inadequate absorption of fats, lactose, bile salts and vitamins, social and personal problems, a reduction of treatment dose or discontinuation, an alteration of the intestinal flora, hemodynamic instability in critical patients and malnutrition. This represents a double declining slope: Clinical and economic, both contributing to reducing survival rates [9]. Regardless of the cause of the OTRD, it is essential to carry out a nutritional treatment that facilitates absorption, reduces waste and digestive symptoms and contributes to the prevention of malnutrition, which is so frequent in the oncological population. We present our action algorithm to supplement the diet of patients with OTRD with an oligomeric enteral nutrition formula
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