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World J Emerg Med. Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth. Patients who are malnourished due to prolonged fasting may present with deficiencies in thiamine, phosphate, magnesium and potassium, which can have extremely negative health consequences if left untreated. These deficiencies can negatively impact the eyes, the kidneys and even the heart.
Medical professionals should understand how to prevent refeeding syndrome in patients with anorexia nervosa and other eating disorders. Doctors should refeed patients slowly, starting with 1, calories per day and increasing by 20 calories each day, to prevent refeeding syndrome. Administering oral vitamins and minerals such as phosphate, calcium, magnesium and potassium can also help prevent refeeding syndrome. Decreased urine output is a critical sign of refeeding syndrome since it indicates an imbalance of fluids in the body.
Some patients are at higher risk of refeeding syndrome than others. The National Institute for Health and Clinical Excellence has established clear criteria for when patients should be monitored for refeeding syndrome. Because alcoholism and chemotherapy also increase the risk of refeeding syndrome, a history of cancer, alcohol or drug abuse may also warrant additional monitoring for refeeding syndrome. Currently, there are clear guidelines on when patients with anorexia nervosa must be admitted to the hospital or to a specialized inpatient unit for refeeding syndrome.
Sometimes, doctors may want to pursue an aggressive refeeding strategy during hospitalization for anorexia nervosa. After all, weight restoration is one of the most important steps in treatment for any eating disorder, as being underweight takes a toll on the health of the body.
According to Eating Disorder Hope , studies of patients receiving 1, calories per day and 1, calories per day indicate that this is safe, as patients receiving 1, calories per day had greater weight gain, shorter hospital stays and, while more likely to require phosphate supplementation, did not develop refeeding syndrome. Aggressive refeeding is sometimes recommended in the United States healthcare system due to shorter hospital stays as a result of privatized healthcare.
Still, doctors should know when not to attempt an aggressive refeeding strategy, even when a patient is hospitalized. Research shows that refeeding syndrome greatly influences the outcomes of patients with anorexia nervosa.
According to the National Institutes of Health , early detection of refeeding syndrome is critical in reducing the mortality of patients with anorexia nervosa. So, which refeeding method is better to reduce the risk of refeeding syndrome and relapse: nasogastric nutrition or meal-based refeeding?
It is important to note that only a subset of patients with heightened risk will develop this life-threatening complication during nutritional rehabilitation. However, treatment providers should regularly monitor at-risk patients for symptoms of refeeding syndrome. Refeeding syndrome symptoms and warning signs typically appear early in the refeeding process, and require immediate medical intervention upon observation.
Its development is completely predictable. Therefore, it is important for all patients with extreme forms of anorexia and ARFID to initiate nutritional rehabilitation in an inpatient medical setting that specializes in preventing, identifying and managing this potentially fatal complication. For more information about refeeding syndrome symptoms and warning signs, contact us.
In addition, fluids are reintroduced at a slower rate. Sodium salt replacement may also be carefully monitored. People who are at risk of heart-related complications may require heart monitoring.
Recovering from refeeding syndrome depends on the severity of malnourishment before food was reintroduced. Refeeding may take up to 10 days, with monitoring afterward. In addition, refeeding often occurs alongside other serious conditions that typically require simultaneous treatment. Healthcare professionals can prevent complications of refeeding syndrome by:.
Refeeding syndrome appears when food is introduced too quickly after a period of malnourishment. Shifts in electrolyte levels can cause serious complications, including seizures, heart failure, and comas. In some cases, refeeding syndrome can be fatal. People who are malnourished are at risk. Certain conditions, such as anorexia nervosa or chronic alcohol use disorder, can increase risk.
Complications of refeeding syndrome can be prevented by electrolyte infusions and a slower refeeding regimen. When individuals who are at risk are identified early, treatments are likely to succeed. Increasing awareness and using screening programs to identify those at risk of developing refeeding syndrome are the next steps in improving the outlook.
Kwashiorkor and marasmus are forms of undernutrition. Learn the difference between these two conditions. This is a detailed article about what you can do to gain weight. These methods work fast, and will improve your health and appearance at the same time.
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