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Enteral and Parenteral Nutrition

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Geriatric Gastroenterology

Abstract

Malnutrition is more common in geriatric population because of higher incidence of chronic disability and disease, but the principles of nutritional support are the same as those for any adult. Nutrition support should be implemented in a step-wise fashion, starting with dietary consultation with a nutritionist with recommendations for dietary change or supplementation. If this fails, nasogastric feeding should be considered. In the presence of anatomic changes in the upper gastrointestinal tract, a more distal postpyloric feeding tube should be considered. Intestinal failure is the only absolute indication for parenteral feeding, but initial PN supplementation may be necessary in the critically ill depleted patient while awaiting enteral feeding (EN). In the vast majority of patients, a simple low-cost polymeric formula will meet EN requirements. Extra care should be taken in the elderly terminal patient to avoid long-term “forced feeding,” whether it be EN, PN, or via gastrostomy, as these interventions are associated with poor outcomes and may actually impair the remaining quality of life.

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Authors and Affiliations

  1. Department of Internal Medicine, Georgetown University Hospital, Washington, DC, USA

    Manie Juneja MD

  2. Department of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Stephen J. D. O’Keefe MD, MSc

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  1. Manie Juneja MD
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  2. Stephen J. D. O’Keefe MD, MSc
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Correspondence to Manie Juneja MD .

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Editors and Affiliations

  1. Hospital, Department of Medicine, Saint Peter’s University, 254 Easton Ave, New Brunswick, 08901, New Jersey, USA

    C. S. Pitchumoni

  2. (North Division), Department of Medicine, Montefiore Medical Center, 600 East 233rd Street, Bronx, 10466, New York, USA

    T. S. Dharmarajan

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Juneja, M., O’Keefe, S.J.D. (2012). Enteral and Parenteral Nutrition. In: Pitchumoni, C., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1623-5_14

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