Nutrition IN Liver AND GI Disease

The answer first

Nutritional assessment and support in patients with liver and gastrointestinal disease is a core physician skill that materially changes outcomes. The FRACP candidate must defend the MUST screening tool for hospitalised patients, the diagnostic criteria for refeeding syndrome (hypophosphataemia less than 0.5 mmol/L within 72 hours of refeeding, with or without hypokalaemia, hypomagnesaemia, fluid overload, arrhythmia), the calorie escalation protocol (start 5-10 kcal/kg/day in high-risk patients, increase over 4-7 days), and the sarcopenia assessment in cirrhosis (skeletal muscle index on CT). The answer-first synthesis is: screen every hospitalised patient for malnutrition, identify high-risk patients for refeeding syndrome before nutritional support, correct electrolyte and micronutrient deficiencies before refeeding, start at low calorie and titrate, and address disease-specific requirements (sodium restriction in cirrhosis with ascites; high calorie and high protein in IBD; fat restriction in chylous ascites). ^{[2] [3]}

References10ShowHide

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