Supportive enteral nutrition in oncological patients

Enteralna prehrana je metoda koja omogućuje unos nutritivnih enteralnih pripravaka peroralnim putem ili primjenom tehnoloških pomagala (sonde i pumpe) u želudac ili tanko crijevo. Enteralna prehrana je pridonijela širenju svijesti o važnosti adekvatne nutritivne potpore u kliničkoj medicini. Indikacije za njenu primjenu su pothranjenost kod bolesnika i bilo kakavo stanje koje može dovesti do urušavanja nutritivnog statusa (Krznarić, 2008). Standardna enteralna prehrana sa dodatkom pripravaka koji sadrže omega-3-masne kiseline može kod takvih pacijenata dovesti do smanjenog gubitka tjelesne težine, smanjenih komplikacija citostatske terapije i radioterapije, inhibiciji upalnih i kataboličkih medijatora. (Krznarić, 2006). Sindrom anoreksije – kahesije često se javlja kod onkoloških bolesnika uz njihovu osnovnu bolest. Prevalencija ovog poremećaja kod osoba oboljelih od karcinoma je između 8% i 88%. Najveći postotak pacijenata s kaheksijom je kod tumora glave,vrata, želuca i gušterače. Tumorska kaheksija je najizraženija u terminalnom stadiju bolesti iako se može pojaviti već u početku same bolesti. Klinički se manifestira anoreksijom, gubitkom tjelesne težine, osjećajem slabosti, umorom, gubitkom mase skeletnih mišića i masnog tkiva, promjenama metabolizma ugljikohidrata,masti i proteina, anemijom, hipertigliceridemijom, hipoalbuminemijom i intolerancijom glukoze. Velik problem koji se javlja kod tumorske kaheksije je nemogućnost podnošenja aktivnog onkološkog liječenja (Dobrila-Dintinjana, R. i sur., 2015). Čak 20% bolesnika oboljelih od karcinoma umire od pothranjenosti a ne od posljedica osnovne bolesti (Krznarić, 2006).Enteral nutrition it a method that enables delivery of enteral nutritional compositions by the oral route or technological aids (probe and pump) in the stomach or small intestine. Enteral nutrition has contributed to the spread of awareness of the importance of adequate nutritional support in clinical medicine. The indications for its use are malnutrition in patients and any condition leading to the nutritional status collapse (Krznarić, 2008). The standard enteral diet supplemented with compositions containing omega-3-fatty acids in such patients may result in reduced weight loss, reduced complications of chemotherapy and radiotherapy, inhibition of inflammatory mediators and catabolic. (Krznarić, 2006). In oncologic patients most commonly associated symptom with their basic illness is the anorexia-cachexia syndrome. Its prevalence among tumor patients is between 8 and 88%. Cachexia occurs with the highest percentage of patients with head, neck, stomach and pancreas tumors. Tumor cachexia is most prominent in the terminal stage of the disease although it may sometimes appear at the beginning of the disease's manifestation. It is clinically manifested by anorexia, weight loss, the feeling of weakness, tiredness, loss of skeletal muscle mass and fat tissue, changes in carbohydrate metabolism, fat and protein, anemia, hypertriglyceridemia, hypoalbuminemia, and glucose intolerance. A major problem that occurs in cancer cachexia is the impossibility of enduring the active oncological treatment (Dintinjana, R. et al., 2015). As many as 20% of patients with cancer die of malnutrition and not as a result of the underlying disease (Krznarić, 2006)