Organization of the stomy patient nutrition. Choice of food substrate

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Abstract

Feeding through an artificial fistula is used to organize the nutrition of patients with prolonged severe dysphagia. Gastrostomy is the most common operation to provide nutrition when oral intake is not possible. According to the information system of the St. Petersburg Territorial Compulsory Medical Insurance Fund, from 01.01.2015 to 10.20.2020, 2391 operations of imposing a nutritional fistula were paid. The choice of a food substrate for feeding an ostomy patient is difficult. Previously, pureed diets of mixed products were used; since 2000, in large hospitals, these diets have been replaced by branded enteral nutrition. The development of malnutrition, up to kwashiorkor and sarcopenia, has been noted in patients receiving an unbalanced pureed diet for a long time. The real properties of the blended diet do not allow it to be introduced into the gastrostomy without dilution with water. Blockage of gastrostomy tubes, due to the density of nutrition, is one of the frequent problems of such nutrition. On the contrary, branded enteral nutrition is fluid, well balanced in terms of the main food nutrients, vitamins and minerals, with a given energy value in small volumes of liquid. With long-term nutrition with commercial mixtures, intestinal dysbiosis develops with a loss of microbiota biodiversity. In the case of feeding a patient with a blended table, microbial biodiversity is preserved, a number of gastroenterological complaints and allergies or food intolerances to artificial nutrition ingredients are stopped. The choice of food substrate for the patient, its combination of wiped table and branded food is under study.

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About the authors

Anna N. Zavyalova

Saint Petersburg State Pediatric Medical University

Author for correspondence.
Email: anzavjalova@mail.ru

MD, PhD, Associate Professor, Department of Propaedeutics Сhildhood Diseases with a Course of General Care

Russian Federation, Saint Petersburg

Valeriya P. Novikova

Saint Petersburg State Pediatric Medical University

Email: novikova-vp@mail.ru

MD, PhD, Dr. Sci. (Med.), Professor, Head Department of Propaedeutics Сhildhood Diseases with a Course of General Care

Russian Federation, Saint Petersburg

Vasiliy I. Orel

Saint Petersburg State Pediatric Medical University

Email: viorel56@list.ru

MD, PhD, Dr. Sci. (Med.), Professor, Head, Department of Social Pediatrics and Public Health Organization AF and DPO

Russian Federation, Saint Petersburg

Maksim V. Gavshchuk

Saint Petersburg State Pediatric Medical University

Email: gavshuk@mail.ru

MD, PhD, Associate Professor, Department of General Medical Practice

Russian Federation, Saint Petersburg

Yuliya V. Kuznetsova

Saint Petersburg State Pediatric Medical University

Email: u-piter@mail.ru

MD, PhD, Associate Professor, Department of General Medical Practice

Russian Federation, Saint Petersburg

Lola A. Davletova

Saint Petersburg State Pediatric Medical University

Email: dav.lol@mail.ru

Assistant Professor, Department of General Medical Practice

Russian Federation, Saint Petersburg

Milad M. Al-Hares

Saint Petersburg State Pediatric Medical University

Email: haresmilad@gmail.com

Assistant Professor, Department of General Medical Practice

Russian Federation, Saint Petersburg

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