Text/Yangcheng Evening News all-media reporter Xue Renzheng correspondent Bai Tian
Photo/Courtesy of the hospital
The people take food as heaven. Eating, in modern life, is not only a survival need, but also a pleasant taste of the tongue. When we are feasting, there is a category of people who can only look forward to food and sigh. They don't want to lose weight, but they don't eat well, drink badly, and sometimes they feel full after only a few bites, they are - gastrointestinal tumor patients.
He Zhiying, attending physician of the Department of Clinical Nutrition of the Third Affiliated Hospital of Guangzhou Medical University (hereinafter referred to as "the Third Hospital of Guangzhou Medical University"), popularized the knowledge of nutritional treatment for patients with gastrointestinal tumors, helped patients with gastrointestinal tumors to quickly, accurately and steadily complete the nutrients needed, and have good physical fitness to build a solid anti-cancer defense line.
Learn to recognize signs of malnutrition and provide timely nutritional support
"Gastrointestinal tumor diseases can affect people's appetite, food intake, digestion and absorption, resulting in weight loss, muscle loss, reduced immunity, and physical weakness." He Zhiying introduced that survey data show that the proportion of malnutrition among gastric cancer patients is as high as 87%, and the incidence of cachexia is as high as 65%-85%, which is the tumor with the most serious nutritional impact on all tumors.
It is understood that the malnutrition caused by gastrointestinal tumors is definitely not only to reduce the weight of patients, but also to reduce the patient's tolerance to surgery, resulting in slow wound healing, and even increasing the risk of disease complications, reducing the effect and tolerance of subsequent radiotherapy and chemotherapy, and eventually prolonging hospitalization time and increasing hospitalization costs.
For patients with gastrointestinal tumors, the key to whether nutritional support is needed is to learn to recognize signs of malnutrition:
The average amount of food eaten in the past week is less than 60% of the usual day;
In the past 1 month, the weight loss is obvious, and the clothes and pants have become significantly larger;
Cannot eat ≥ for 7 days;
In the presence of one of the above conditions, nutritional therapy should be initiated immediately.
He Zhiying introduced that the best time for nutritional treatment is before and after surgery, before chemotherapy, radiotherapy or within 2 weeks of the start. Nutritional therapy during this time can help maintain weight, reduce gastrointestinal side effects such as nausea and vomiting caused by chemotherapy, and reduce intestinal mucosal damage caused by radiation therapy. At the same time, nutritional supplementation should also be adhered to between radiotherapy and chemotherapy.
At present, nutritional support is mainly divided into the following three categories:
1. Oral nutritional supplementation
Refers to oral nutrient solution. Simple, easy, affordable, in line with physiological needs, is the first choice for patients with gastrointestinal tumors.
2. Enteral nutrition support
Refers to the way in which nutrient solution or food homogenizer enters the digestive tract through the gastrointestinal tube or gastrointestinal ostomy mouth, with a complete variety of nutrients, good absorption, and helps to restore gastrointestinal function with fewer complications.
3. Parenteral nutrition support
Refers to transvascular infusion of drug nutrition rehydration, only for patients with complete intestinal obstruction, severe anastomotic leak, intestinal failure and other patients who cannot eat or feed by mouth, the cost is higher, it is a helpless choice, and it is only used for transitional use.
Many patients have asked why they are still deficient in nutrients after infusing several bottles of albumin? He Zhiying introduced that because the tumor is a wasting disease, malignant tumors absorb too much nutrients from the body, which will cause hypoproteinemia in the human body. Albumin transfusion is generally used for disease treatment needs, is an emergency use, can raise the patient's plasma albumin level to normal, and is not a nutritional support method. Later, patients still need to rely on the absorption of synthetic albumin from food.
Be careful with nutritional misunderstandings
1. Protein powder can not replace nutrient solution
In recent years, with the pursuit of healthy beauty by modern people, protein powder has gradually been sought after by various sports and fitness enthusiasts. However, for patients with gastrointestinal tumors, eating only protein powder is not helpful for improving nutritional status. Dr. He Zhiying reminded that protein powder can only supplement protein, and there are no other nutrients. When the overall diet is insufficient, it is an unbalanced nutritional supplement.
Therefore, it is difficult to use protein powder alone in the case of malnutrition. How much protein powder do I need? How do they work together? It needs to be used under the evaluation of a professional nutritionist.
Improving nutritional status as a whole requires balanced absorption of multiple nutrients. Nutrient solution is in accordance with national standards, the use of food raw materials made of powder or liquid, called enteral nutrition preparations or special medical use formula food (special medical food), containing all kinds of nutrients needed by the human body, there are a variety of disease types of nutritional powder, adapt to the body's different metabolic conditions and gastrointestinal function, can supplement the diet is insufficient or completely replace the diet, such as infant formula is suitable for babies to use a special medical food.
Nutritional contrast of nutrient solution with common postoperative diets
2. The nutritional value of soup water is extremely low
The soup is liquid, but it is considered to be rich in nutrients due to meat, medicinal herbs, etc. In fact, the nutritional value of soup water is extremely low! Even if it is the old Guangliang soup, more than 90% of the nutrition remains in the soup residue.
3. No need to blindly quit "hair"
"Hair" is a folk concept and involves a wide range of foods. In fact, in science, there is no such thing as "hair". In medical nutrition, "hair" can essentially lead to food allergy reactions. Therefore, as long as you eat foods that you often eat before surgery and do not have allergic reactions, you can eat them with confidence after surgery.
Dr. He reminded that if you blindly quit your mouth and hair, reject many foods rich in protein, and only eat staple foods (porridge, rice, flour), it will cause poor nutritional status and affect disease recovery.
How to eat after surgery? Gastrointestinal tumor postoperative diet three steps
After trying to eat at each stage, a small number of meals, 5-8 meals can be arranged every day, at least 3 days without nausea, vomiting, bloating, abdominal pain, diarrhea, etc., you can go to the next stage of eating, and finally return to a normal diet. Here's a demonstration of a recipe for postoperative semi-liquid food:
Postoperative half-flow diet – demonstration recipe
He Zhiying reminded that after discharge, patients also need nutritional support. For patients with obvious postoperative weight loss (more than 5 kg), thinner body size, and postoperative need for postoperative radiotherapy and chemotherapy, especially patients with gastrointestinal tumors, mostly accompanied by loss of appetite, it is recommended to continue to use enteral nutrient solution to supplement the insufficient part of the diet after discharge, and can drink 2-3 cups per day; patients with large stomach reactions can have a small number of meals (50ml-100ml each time, arrange 5-8 meals).
Patients with gastrointestinal tumors, especially those with gastric cancer, should weigh and record them every two weeks, and visit the nutrition clinic of the hospital regularly, at least once every 3 months, to develop the habit of long-term oral supplementation. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | He Ning