Tag Archives: patient nutrition

Tackling Difficult Pediatric Feeding Problems: A “Whole Child” Approach

Douglas G. Field, M.D.

Douglas G. Field, M.D.

Proper daily nutrition is a necessary part of growth and development and usually a source of comfort and pleasure. But for many pediatric patients with congenital or acquired medical issues or behaviorally-based impairments, “Feeding problems can be a source of stress for patients, parents, family members, and may endanger the child’s overall health and development,” according to Douglas Field, M.D., a pediatric gastroenterologist and medical director of the Penn State Hershey Pediatric Feeding Program.

Field, along with Keith Williams, Ph.D., B.C.B.A., director of the pediatric feeding program and practicing behavioral psychologist, have tailored the program to provide diagnostic, treatment planning, and interventions for children with problems ranging from food refusal to motor impairments that hinder proper swallowing. Prior to their appointments at Penn State Hershey, both Field and Williams worked in the Pediatric Feeding Disorders Program at the Kennedy Krieger Institute in Baltimore, Maryland. Continue reading

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Addressing Patient Nutritional Needs in Complex Abdominal Surgery and Intestinal Failure

The pre-treatment nutritional status of patients with acute abdominal injury, or chronic gastrointestinal (GI) illness plays a large role in post-surgical course of recovery. Likewise, their ability to obtain nutrition after treatment significantly impacts long-term health outcomes and quality of life.

David Soybel, M.D.

Physicians at Penn State Hershey Medical Center and Penn State College of Medicine are investigating how to better detect and address nutritional needs before and after major complex GI surgery. According to David Soybel, M.D., “A significant proportion of patients with complex medical histories have pre-existing deficiencies in specific micronutrients such as zinc, copper, selenium, and magnesium. Major procedures place high demands on already compromised micronutrient stores, and often put these patients into a state of ‘micronutrient distress’ that may be associated with longer and more complicated recovery.”

Soybel’s research aims to establish methods to routinely detect and treat these deficiencies in high-risk patients, both before and after surgery. “Pre-surgical recognition of micronutrient deficiencies would provide the opportunity for micronutrient repletion and other interventions, and better prepare patients to get well post-surgery,” says Soybel. “Likewise, in acute situations, recognition of such deficiencies and rapid intervention could help patients better recover after emergency procedures.”

Gordon Lee Jensen, M.D., Ph.D.

Based in State College and one of few physicians in the country who specializes in management of intestinal failure, Gordon Lee Jensen, M.D., Ph.D., explains, “In the past, many of these intestinal failure patients would have died or become indefinitely dependent on intravenous, total parenteral nutrition (TPN). But now, because of new medications and advances in medical nutrition therapy, some can eventually come off of TPN and lead more normal lives. Today, TPN is more often a temporary supportive measure. Successful transition off of TPN depends on a number of factors. If a patient has at least 100 cm of small bowel length and a portion of intact colon (or at least 150 cm of small bowel and no functional or intact colon), and residual disease is controlled, then the odds are favorable for them to eventually adapt to enteral or oral nutrition.” Continue reading

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