Eating disorders Flashcards
How would you explain the cause of re-feeding syndrome?
Re-feeding syndrome happens when a patient starts to eat at faster than advised rate following a period of starvation.
When in starvation the body survives by breaking down fat and this can deplete stores of salts and minerals
However when the patient begins to eat the body needs to switch from breaking down fats and instrad over to carbohydrates
In order to break down carbohydrates and store these sugars it can lead to further decline of salts and minerals in the blood and result in fluid gathering in parts of the body
What are the risks of re-feeding syndrome?
Re-feeding syndrome is not only troubling for the patient due to distressing syndromes but it is a medical emergency and if confirmed requires management in a medical hospital
That is because if the level of these salts and minerals fall too low it can leads to funny rhythms in the heart, as well as seizures
Additionally if fluid accumulates too rapidly it can cause heart failure and if severe there can be a risk of death
How can we prevent re-feeding syndrome?
Re-feeding syndrome can be prevented in a number of ways:
Manage in a MDT manner including input from dieticians, psychology and medical doctors if required.
Firslty we will slowly start the amount of calories you eat and slowly increase - 1000–350 kcal/day. If oral foods are difficult we can do liquid foods/supplements. In terms of weight gain we will aim to increase your weight 0.5-1kg a week if inpatient and out patient 0.5kg a week. We will aim not to increase your weight more than 2kg a week. Note the weight aim is the premorbid weight or the weight that periods stopped + 5kg.
Secondl we will start you/the patient on a thiamine, B12 and a multivitamin prior to starting feeding and continue this for the first 10 days
We will also perform daily bloods to monitor for the risk and conduct an ECG at the start and if there any abnormalities on the bloods/symptomatic.
If the salt or mineral levels are low we can correct these. If we are worried that you may have re-feeding syndrome we will send you to a medical hospital/A&E to be investigated and treated if needed.
