Oligomeric Enteral Nutrition in Undernutrition, due to Oncology Treatment-Related Diarrhea. Systematic Review and Proposal of An Algorithm of Action

• Published in: Nutrients 2019-08, Vol.11 (8), p.1888
• Main Authors: Sanz-Paris, Alejandro, Martinez-García, María, Martinez-Trufero, Javier, Lambea-Sorrosal, Julio, Calvo-Gracia, Fernando, López-Alaminos, María Elena
• Format: Article
• Language: English
• Subjects: Algorithms; Antineoplastic Agents - adverse effects; Clinical Protocols; Diarrhea - chemically induced; Diarrhea - physiopathology; Diarrhea - therapy; Enteral nutrition; Enteral Nutrition - adverse effects; Enteral Nutrition - methods; Food, Formulated - adverse effects; Humans; Intestinal Absorption; Malnutrition - chemically induced; Malnutrition - physiopathology; Malnutrition - therapy; nutritional algorithm; Nutritional Status; Nutritive Value; oligomeric enteral nutrition formula; Oncology; oncology treatment related diarrhea; Organism Hydration Status; Radiation Injuries - etiology; Radiation Injuries - physiopathology; Radiation Injuries - therapy; Radiotherapy - adverse effects; Review; Risk Factors; Systematic review; Treatment Outcome
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11081888

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.