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Refeeding Syndrome

Refeeding Syndrome

Refeeding syndrome or refeeding syndrome is a condition that can occur due to inappropriate nutritional therapy for patients with chronic malnutrition, including kwashiorkor and marasmus. If left untreated, refeeding syndrome can cause death.

Malnutrition can change the body's metabolism in processing nutrients. For example, a body that does not get sufficient amounts of carbohydrates to be processed into energy will take fat and protein stores.

Over time, this condition can affect phosphate levels, which is a type of electrolyte that helps the body convert glucose into energy.

Malnutrition can be treated by refeeding , which is giving nutrients through a feeding tube or infusion. However, if the sufferer's body receives nutrients too quickly, electrolyte levels can become unbalanced. This condition can interfere with organ function so that sufferers are at risk of experiencing refeeding syndrome .

Causes of Refeeding Syndrome

Refeeding syndrome can occur when a malnourished person's body receives nutrients too quickly or in large quantities. In addition, there are a number of factors that can increase a person's risk of developing refeeding syndrome , namely:

  • Weight loss in 3-6 months
  • Have a body mass index below 18
  • Excessive consumption of alcoholic beverages
  • Have conditions that cause malabsorption, such as inflammatory bowel disease, cystic fibrosis , and short bowel syndrome
  • Suffer from eating disorders, including anorexia nervosa and bulimia
  • Have uncontrolled diabetes
  • Excessive use of antacids or diuretics
  • Suffering from metabolic disorders due to cancer treatment
  • Undergoing treatment of morbid obesity with extreme diets

Symptoms of Refeeding Syndrome

Symptoms of refeeding syndrome usually appear about 4 days after the start of the refeeding process . Symptoms and signs of refeeding syndrome can include:

  • Stomach ache
  • Nausea and vomiting
  • Muscle ache
  • Easily tired or lethargic
  • dazed
  • Difficulty breathing
  • High blood pressure
  • seizures
  • Heart rhythm disturbances ( arrhythmias )
  • Coma

When to see a doctor

Immediately go to the nearest hospital emergency room to consult a doctor if you or your family experience symptoms of refeeding syndrome . It is important to remember that a doctor's examination needs to be done immediately to prevent the condition from getting worse.

Diagnosis of Refeeding Syndrome

To diagnose refeeding syndrome , the doctor will conduct questions and answers regarding the patient's symptoms and medical history, accompanied by examination of vital signs such as blood pressure and pulse.

Next, the doctor will do a blood test to detect signs of refeeding syndrome , which can be:

  • High blood sugar ( hyperglycemia )
  • Low phosphate (hypophosphatemia)
  • Low sodium in the blood (hyponatremia)
  • Low potassium ( hypokalemia )
  • Low magnesium (hypomagnesemia)

Refeeding Syndrome Treatment

Treatment for refeeding syndrome will be adjusted to the severity of the patient's condition. In patients who experience severe symptoms, the doctor will first provide treatment so that their condition returns to stability.

If the patient's condition is stable, the doctor will take action to prevent the symptoms of refeeding syndrome from recurring. A number of treatments that doctors can perform at the hospital include:

  • Providing nutrition slowly, by increasing calories little by little
  • Administration of fluid infusion according to the patient's condition

Complications of Refeeding Syndrome

Refeeding syndrome is a potentially life-threatening condition. This condition can cause several complications in sufferers, such as damage to the heart, brain, or kidneys. In fact, refeeding syndrome can also cause death

Refeeding Syndrome Prevention

The effort to prevent refeeding syndrome is to reduce the risk of complications. Some ways that doctors can do are:

  • Evaluate the health conditions of people at risk of experiencing refeeding syndrome
  • Determine the refeeding program that is suitable for the condition of people with malnutrition and other health problems
  • Supervise the provision of nutrition and fluids to malnourished patients
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