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This has been "news" for maybe 15 years (or more?). Heath care moving a glacier pace.

Like @SNT Gatchaman I think this will be from what has been learned through collaboration with other specialities in multi-disciplinary teams. That's the cases where I've come across it at least. With eating disorders we were told patients are manipulative, but then the focus was that sometimes...

But you see the same with nutrition itself. I met a doctor at the NICU who told me milk allergy meant someone had to stay away from lactose/milk sugar (for those who don't know, milk allergy is to milk protein, typically the casein). I have no idea if this was a one-time mistake on the part of...

The use of PEG over NG is already in general guidelines for nutritional support, if it is believed support is needed for more than 4-6 weeks PEG should be preferred over NG. Other patient groups certainly also have issues getting nutritional care, although that seems to be more about lack of...

Worms that can survive with only about 25% of their genetic material (given the environment is supportive enough, ie no need for genes that convert one amino acid to another since all amino acids are provided etc) o_O

I was talking to my mother about the case, and she said they never had a problem feeding someone lying down when she worked as a nurse, it happened often enough that it was easier/better to do so so they did. I have to look up if this correlates with some change in clinical practice since she...

I might be biased, but I feel malnourishment is a medical issue. And if someone is not getting nutrition - they will die, so if enteral is not possible then parenteral is the only next step. I can't remember that non-functioning gut is a requirement for TPN, because again if all other avenues...

A PEG can be adviseable if nutrition support are assumed to last longer than 4-6 weeks, that's really all that is needed to use a PEG over a nasogastric tube. When it comes to total parenteral nutrition, I'm not sure I know of any example where it would be used and it wasn't for the intestines...

There are nutrition drinks that cannot be used as sole sources of nutrition, but there are more that can be.

If they follow ESPEN it should be the case. Though BAPEN write on their site on parenteral nutrition (which says it is to be updated): "Parenteral nutrition(PN) refers to the provision of nutrients by the intravenous route. In general, PN should only be used when it is not possible to supply...

Reducing (or adding) environmental stimuli is one of the first things to try when helping someone eat. A problem I think can occur with (severe) ME is that the reasoning behind changing the environment is cost effectiveness/low resource avoiding having to use more invasive nutrition treatment...

Thank you for the clarification @MrMagoo :)

So the documents mentioned are what DCC provide their employees as information on ME?

I don’t understand what the DCC documents are. Could someone explain? Thanks for the recap @Nightsong!

I don't know the details on how much the thickness need to change before it becomes a problem, but the increased intestinal permeability is associated with worse outcomes (and sepsis, though apparently not what they argue here).

On the atrophy of the intestines with TPN, there are studies on morphology of the intestinal wall following a period of TPN feeding, such as this one: https://pubmed.ncbi.nlm.nih.gov/8748359/ I’ll note I haven’t assessed the evidence for this, only been taught that it happens. @lunarainbows

Malnutrition isn't, as has been stated in numerous reports from healthcare all over the world. For most it "only" gives longer hospital stays with more complications and readmissions and potentially worse prognosis going forward, but as was the case here there are also deaths. Edit to add...

@MSEsperanza With fluid there are f.ex common signs of dehydration to look for, but also doing an interview and calculating how much fluid someone takes in and compare to what they are presumed to need. If making a diet plan with tube feeding the liquid feeding solution would be part of both the...

Weight measured weekly, together with using a height measurement to look at BMI. This and a short food interview would be most common and easiest to do for someone not trained in nutrition. Well for the food interview training helps but for someone who is an inpatient they’re not always asked...

Total energy expenditure is broken into three: basal metabolic rate (BMR, what is needed to maintain vital functions etc), diet induced thermogenesis (DIT) and physical activity. If the other two components are reduced the contribution from DIT on total energy expenditure could increase. Being...