Wednesday, June 7, 2017

Appetite Stimulants

In some cases, persistent anorexia can be remedied with the use of appetite stimulants.Artificially stimulating the appetite will improve nutritional intake which positively impacts overall health status. The PLWHA feels better and the normal hunger and appetite mechanisms can improve substantially The goals of nutrition support are to meet anticipated nutrient needs using the appropriate modality, to correct malnutrition, to maintain or replete lean body mass, to preserve gut function and to maintain psychosocial well being. Enteral nutrition provides specialized formula via a feeding tube to the gastrointestinal tract, and should be considered for persons who are unable to meet nutritional needs orally. Enteral feeds are contraindicated when there is an indication for bowel rest, a non-functional small intestine, or mechanical obstruction of the gastrointestinal tract.

Methods of Enteral Nutrition Support

Selection of the feeding method depends on the anticipated duration of support, clinical factors and the goals of treatment. Whenever possible, the stomach is the preferred route for tube feeding because it serves as a reservoir which slows intestinal transit and allows for enhanced osmotic regulation. Enteral feeds are provided by one of the following methods:

Nasogastric: A nasogastric tube feeding is recommended for short term feeding, and should be promptly implemented for nutritional repletion of malnourished individuals during hospital admissions. Nasogastric feeding tube placement may be contraindicated in the presence of esophageal lesions, emesis, and severe gastroesophageal reflux.

Gastrostomy: A percutaneous endoscopic gastrostomy (PEG) feeding tube is placed for long term tube feeding and/or home enteral nutrition.

Jejunostomy: In cases of recurrent emesis or gastroesophageal reflux, which incur a high risk of aspiration, a gastro-jejunostomy or jejunostomy feeding tube may be more appropriate.

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