Psychological Aspects Of Gastrointestinal Disease

Question 1

What psychological problems can be caused by GI disease?

Answer 1

Conditioning 
Nausea and vomiting 
Loss of appetite/weight loss 
Diarrhoea 
Sexual problems

Question 2

What psychological problems can present as GI disease?

Answer 2

Stress
Anxiety
Depression
Eating disorders

Question 3

What criteria identifies people at high risk of developing refeeding problems?

Answer 3

Patient has one or more of the following:
BMI less than 16kg/m2
Unintentional weight loss greater than 15% within the last 3-6 months
Little or no nutritional intake for more than 10 days
Low levels of K, P or Mg prior to feeding
OR
Two or more of the following:
BMI less than 18.5kg/m2
Unintentional weight loss greater than 10% within the last 3-6 months
Little or no nutritional intake for more than 5 days
History of alcohol abuse or drugs including chemotherapy, antacids, diuretics or insulin

Question 4

What initial steps should be taken in the management of refeeding syndrome?

Answer 4

Correct fluid depletion (cautiously)
Give thiamine at least 30 mins before feeding starts
Feed at 5-10kcal/kg over 24 hrs
Gradually increase feeding to requirement over a week

Question 5

What levels of phosphate, potassium and magnesium needs replacing in cases of refeeding syndrome?

Answer 5

Phosphate- below 0.3mmol/l
Potassium- below 2.5mmol/l
Magnesium- below 0.5mmol/l