GASTROINTESTINAL SYMPTOMS IN ENTERALLY FED ADULTS AND CHILDREN WITH NEUROLOGICAL CONDITIONS

Although there is currently no consensus definition of ‘enteral feeding intolerance’,^1,2 clinical manifestations may include nausea, vomiting or regurgitation, diarrhoea, abdominal pain, abdominal distension and high gastric residual volumes.^1-3 These symptoms may hinder the delivery of enteral formula, with implications for nutritional status. The presence of a neurological disorder may further complicate this clinical picture, owing to the complex gut-brain relationship and medical treatments that may impact on GI function.

To help guide clinical practice in this complex area, a working group of specialist dietitians and a consultant neuro-gastroenterologist met in January 2018 with the aim of developing a pragmatic guidance tool. Clinical experience and relevant evidence were drawn upon to form consensus opinions. The need for pragmatic guidance based on clinical judgement and best practice was highlighted where there was a lack of supporting data. Design of the tool was based on the discussions of the working group, the details of which are documented on the tool itself.

92% of children with cerebral palsy had clinically significant gastrointestinal symptoms.⁴ From a survey, dietitians estimate 83% of their adult patients with neurological disorders* experience gastrointestinal symptoms on a standard feed.⁵

This new resource has been created to help guide clinical practice in this area. It has been adapted from an experience-based, multidisciplinary tool created as an outcome of a working group and where insufficient evidence exists, recommendations are based on best practice.